Graft Quality Control with the Traditional Roller Pump Flow Measurement in Comparison to the Transit-Time Flow Measurement

Objective: Vein graft quality control had been traditionally done for more than 20 years with a roller-pump flow measurement (RPFM) in our institute until off-pump coronary artery bypass grafting was introduced as the standard technique of myocardial revascularization in the year 2009 in our institute. In this study, the RPFM method was compared with the Transit-time flow measurement (TTFM). Patients and Methods: From February to September 2005, 31 patients (5 females) undergoing CABG in our institute were included into the study. All the patients were operated with cardiopulmonary bypass. In those patients, 27 distal anastomoses were done with the left internal thoracic artery and 99 anastomoses were done with vein grafts. Those 99 vein graft were assessed both, with the RPFM method and TTFM method. Results: CABG could be safely performed in all cases. In all target vessels, the RPFM method overestimated bypass flow compared to the TTFM method, and simple linear regression revealed no correlation between the TTFM measurement and the RPFM measurement (r = 0.08, p = 0.21). There were two cases in which a graft problem could be detected only with TTFM method, even in our small patient cohort. Conclusion: The present study suggests that the TTFM method is clearly superior to the traditional RPFM method and we believe now that TTFM should be performed routinely in all CABG to improve patient care and quality of surgical results.