Ramírez JK, Abi-Rezk MN, Colao JY

Language: Spanish
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ABSTRACT

According to the WHO, coronary heart disease is the leading cause of death worldwide, associating, among other factors, a higher life expectancy and the growing prevalence of comorbidities such as diabetes mellitus and hypertension. The recommendation of surgical treatment in the different guidelines for action as the approach of choice for complex lesions of the coronary tree in non-acute conditions, and the fact that between 7-15% of the grafts are occluded before hospital discharge and up to 30 % in first year, largely due to faults in the technical quality of the grafts, has led to the development of different methods for the intraoperative evaluation of the hemoducts. The objective of this research is to elucidate which is the most suitable, safe, cost effective and reproducible of the available ones. Being able to conclude that in spite of the conventional angiography is the goldstandard for the intraoperative evaluation, is not adaptable to the needs described before, making impossible to generalize its use. Transit time flow measurement is a simple method to perform, harmless for the patient and the operator, and economical, allowing to objectively evaluate the quality of the grafts with a specificity of up to 98.4%, a sensitivity that ranges from 25% - 96%, and a positive predictive value that reaches 100% when used in conjunction with other methods such as Epicardial Ultrasonography, thus being considered as the most appropriate intraoperative tool.