Analysis Of Blood Flow In Sequential Saphenous Vein Grafts In Offpump Coronary Artery Bypass Grafting

Objectives:With the change of the people’s living habits and diet structure, coronary heart disease(CHD) has become a major killer of human health.Coronary artery bypass grafting for treatment of coronary heart disease has been widely used.Now more to the LIMA and Saphenous vein blood vessel materials as a bridge.This study under the extracorporeal circulation through the use of instant flow meter (transit time flow measurement, TTFM) measuring blood flow, the method of sequential bridge monitoring of great saphenous vein bridge parameters such as blood flow and pulsation index, which is used to monitor the operation.Methods:Between May 2014 and May 2015 were retrospectively analyzed in 50 patients undergoing extracorporeal circulation during coronary artery bypass grafting (OPCAB),31 cases of men, womenl9 cases, aged 55 to 75 years old, weight 55-80 kg, intraoperative full use of the anterior descending LIMA anastomosis, the rest of the target with saphenous vein sequential anastomosis, anastomotic line bypass grafts 215, an average of 4.3, the saphenous vein sequential anastomosis,165, an average of 3.3.Intraoperative after being finished all vascular anastomosis, cycle stability, first of all the saphenous vein bridge completely natural flow condition, about 2 cm in the proximal anastomosis of great saphenous vein bridge measurement in the TTFM blood flow and pulsation index (PI) and record the data (method a);Then use the pug along the great saphenous vein bridge from the proximal to distal, temporary clip respectively under test bridge on the far side of anastomotic vessels, using TTFM proximal in bridge vascular anastomosis under test measure 2 cm, record the anastomotic with aortic anastomosis between the blood flow and pulsation index (PI), and other data (method 2), and compare the two methods of data.All data using SPSS 16.0 software for statistical processing and analysis of count data with standard deviation of mean soil pulling soil s (X), according to statistical analysis using the t test.:difference was statistically significant (P< 0.05).Results:(1) All of the patients in gender, age, coronary heart disease risk factors and related history had no statistical difference (P> 0.05);EF cardiac function indexes such as there was no significant difference.Methods the measured average diagonal branch flow (65+/-32.15 ml/min) and PI (2.390.81) soil, with a blunt edge, on average, blood flow (59.65+/-30.27 ml/min) and PI after soil (2.052.05), left ventricular blood flow to the average (42.83+/-28.15 ml/min) and PI (1.82 to 0.86) soil;Method 2 measured average diagonal branch of blood flow (28.35+/-14.25 ml/min) and PI (2.891.20) soil, with a blunt edge, on average, blood flow (27.15+/-14.25 ml/min) and PI after soil (2.602.60), left ventricular blood flow to the average (25.28+/-13.25 ml/min) and PI (2.25 1.20) soil.Method 2 is a measured sequential anastomotic blood flow decreased significantly (P<0.05) value of PI is a significantly increased (P< 0.05);Two methods of measured anastomotic diastolic blood perfusion rate> 50%, there was no statistically significant difference.(3) intraoperative no complications related to measurement, all 12,24 hours postoperatively in patients with CIC-MB were in normal range, no serious ventricular arrhythmia, perioperative myocardial infarction and low cardiac output syndrome and other complications.Postoperative angina symptoms disappear.Conclusions:Sequential bridge vascular trunk blood flow velocity is higher than single bridge, than have big advantages, not easy to have a blood clot blood flow.Observable anastomotic patency cases at the same time, if there are any problems can be adjusted in timely, so as to improve the success rate of bypass surgery.