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Objective:To investigate the potential guiding role of fractional flow reserve(FFR) in surgical revascularization by comparing the relationship between coronary fractional flow reserve(FFR) and blood flow pattern status of bypass graft.Methods:A total of 86 patients with coronary artery disease between March 2016 to October 2019 were included in the study, with 59 males and 27 females; the age ranged from 42 to 77 years old, with an average of(58±12) years old. According to the measured FFR value of the left anterior descending artery, they were divided into severe ischemic group(FFR<0.75), boundary group(0.75≤FFR<0.80) and mild ischemic group(FFR≥0.80). Transit time flow meter(TTFM) was used to evaluate the blood flow status of the bridge vessel from the left internal thoracic artery to the left anterior descending coronary artery.Results:Mean graft flow(MGF) was measured at(21.24±5.71)ml/min, (18.25±7.72)ml/min, (16.47±7.83)ml/min in severe ischemic group, boundary group and mild ischemic group. The results of mean pulsatility index(PI) was 2.58±0.96, 3.14±1.19 and 3.53±1.34, the ratio of diastolic flow during the entire graft flow was 0.63±0.10, 0.55±0.11 and 0.53±0.11, patients appeared systolic reverse flow was 2 cases(3.6%), 3 cases(18.8%) and 3 cases (20.0%), respectively. There were statistically significant differences in MGF( P=0.027)、PI( P=0.007)、the ratio of DF( P=0.001) and the quantity of patients appeared systolic reverse flow( P=0.027) between the three groups. Conclusion:Due to increasing severity of coronary artery stenosis, MGF and the ratio of diastolic flow increased, and there appears to be an decreased PI and quantity of patients appeared systolic reverse flow. The chance of bypass graft occlusion may increase for the near and middle term in mild to moderate functional coronary artery stenosis(FFR≥0.75). For patients with severe functional coronary artery stenosis(FFR<0.75), it can obtain satisfactory flow parameters and ideal clinical outcomes.
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Objective:To analyze the influence of application of bilateral internal mammary artery(BIMA) with different configurations in coronary artery bypass grafting(CABG).Methods:From January 2018 to December 2020, 82 patients underwent CABG using BIMA were included, with 75 males and 7 females, aged(56.9±9.8) years old. According to the target of coronary artery of BIMA, patients were divided into two groups, 23 patients(group B) who underwent the traditional operation(RIMA to the right coronary artery), and 59 patients(group L) whose RIMA were grafted to the left ventricular arteries. Also the patients were divided into two groups according to the RIMA used either in situ(group I, 57 cases) or free(group F, 25 cases). Compare the grafts flow between groups. The CTA angiography of coronary artery was completed to evaluate the grafts patency before discharge.Results:There was 1 early operative death(1.22%). The mean flow(MF) of RIMA was significantly higher in group B( P=0.013). The pulsatility index(PI) of LIMA was significantly lower and the MF of RIMA and BIMA was higher(all P<0.05), fewer patients with LIMA-MF less than 15 ml/min( P=0.023)in the group I. CTA angiography before discharge showed that only 1 RIMA to right coronary artery was occlusion. Conclusion:It is better to use BIMA in situ in CABG, RIMA used in right coronary artery can receive more satisfactory graft flow. BIMA has good patency in early stage, therefore is the ideal and stable coronary bypass graft.
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@#Objective To evaluate the changes of the flow parameters before and after the anastomotic port exploration and dredging during coronary artery bypass grafting by using the transit time flow measurement (TTFM). Methods A total of 167 patients who underwent continuous coronary artery bypass grafting and anastomotic port exploration and dredging surgery in Beijing Anzhen Hospital from 2018 to 2019 were enrolled in this study. There were 136 male and 31 female patients aged 41-82 (58.35±17.26) years. If the probe entered and exited the anastomotic port smoothly, it was recorded as a non-resistance group; if the resistance existed but the probe could pass and exit, it was recorded as a resistance group; if the probe could not pass the anastomotic port for obvious resistance, it was recorded as the stenosis group. In the stenosis group, the grafts were re-anastomosed and the flow parameters were re-measured by TTFM. Results A total of 202 anastomotic ports were carried out by exploration and dredging. Among them, 87 anastomosis (43.1%) were in the non-resistance group, and there was no significant change in the blood flow volume (BFV) and pulsatility index (PI) before and after exploration and dredging (6.16±3.41 mL/min vs. 6.18±3.44 mL/min, P=0.90; 7.06±2.84 vs. 6.96±2.49, P=0.50). Sixty-four anastomosis (31.7%) were in the resistance group, the BFV was higher after exploration and dredging than that before exploration and dredging (17.11±7.52 mL/min vs. 4.96±3.32 mL/min, P<0.01), while the PI was significantly smaller (3.78±2.20 vs. 8.58±2.97, P<0.01). Fifty-one anastomosis (25.2%) were in the stenosis group, and there was no significant change in the BFV and PI before and after exploration and dredging (3.44± 1.95 mL/min vs. 3.48±2.11 mL/min, P=0.84; 10.74±4.12 vs. 10.54±4.11, P=0.36). After re-anastomosis, the BFV was higher (16.48±7.67 mL/min, P<0.01) and the PI deceased (3.43±1.39, P<0.01) than that before exploration and dredging. Conclusion The application of anastomotic exploration and dredging can reduce the occurrence of re-anastomosis, and promptly find and solve the stenosis of the distal coronary artery, improve the poor perfusion of distal coronary, and thus improves the prognosis of patients.
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A partir das revistas Sou Mais Eu, Junior e Men's Health Portugal, segmentadas, respectivamente aos públicos feminino e de classe popular, gay e masculino heterossexual, e com base em discussões relativas ao gênero, aos movimentos do tempo e à sexualidade, o presente artigo propõe uma reflexão acerca dos sentidos então acionados sobre a relação entre os corpos e a passagem do tempo. Ainda que o corpo que se insere nos padrões estabelecidos de beleza seja relevante para Sou Mais Eu, de modo geral, as vivências cotidianas e os desafios narrados pelas leitoras parecem ser mais estruturantes, em Junior e em Men's Health Portugal, o envelhecimento (ou o não envelhecimento, mais propriamente falando) são compreendidos a partir de uma lógica que insere o corpo como essencial naquilo que se refere ao acesso a uma posição dominante. Ser jovem, aí, representa um elemento central no que tange à aquisição de uma posição hegemônica de masculinidade. (AU)
Based on the magazines Sou Mais Eu, Junior and Men's Health Portugal, segmented, respectively, to the public feminine and from a popular class, gay and masculine and heterosexual, and based, as well, on the discussions about gender, time flow and sexuality, this article proposes a reflection about the senses that are moved about the body and about the passage of time. Although the body that is inserted in the established standards of beauty is relevant, for Sou Mais Eu, in general, the daily experiences and the challenges narrated by the readers, seem to be more important, in Junior and Men's Health Portugal, to get old (or not get old, more properly speaking) are understood from a logic that inserts the body as an essential in what concerns access to a dominant position. Being young, there, represents a central element in the acquisition of a hegemonic position of masculinity. (AU)
A partir de las revistas Sou Mais Eu, Junior e Men's Health Portugal, dirigidas, respectivamente a las mujeres de clase popular, a los gays y a los hombres heterosexuales, y basado en las discusiones relacionadas con el género, los movimientos del tiempo y la sexualidad, este artículo se propone a una reflexión acerca de los sentidos movidos sobre el cuerpo y sobre el paso del tiempo. Aunque el cuerpo injerido dentro de los padrones de belleza sea relevante, para Sou Mais Eu, en general, la experiencia cotidiana y los problemas narrados por las lectoras, parece ser más importante. En Junior y en Men's Health Portugal, el envejecimiento (o el no envejecimiento, por así decir) se entienden a partir de una lógica que inserta el cuerpo como esencial a lo que se refiere al acceso a una posición dominante. Es decir, ser joven, en estas revistas, representa un elemento central cuando se refiere a la adquisición de una posición hegemónica de masculinidad. (AU)
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Humans , Male , Female , Body Image/psychology , Gender Identity , Sexuality , Aging , Esthetics , Narration , Time FactorsABSTRACT
Objective To study the value of parameters of Transit-Time Flow Measurement(TTFM) as predictor and judge for one-year after coronary artery bypass transplantation in patency rate of vessel grafts .Methods Parameters of quantity of blood flow and the value of PI( pulsation index) were measured and recorded by intraoperative TTFM in CABG .One-year of follow-ing up, coronary artery CT or coronary angiography examination were accomplished.Results Our study include artery grafts 46(including LIMA grafts 44, RIMA graft 1 and radial artery graft 1) with the patency rate of grafts 91.3％ for one-year after CABG, and vein grafts 48 with the patency rate of grafts 66.7％ .There exists statistically significant difference between above two groups(P<0.001).High PI is independent risk factor(P =0.037) in patency rate of vessel grafts for one-year after CABG by binary logistics regression analysis but no other parameters have the statistical significance (P>0.05) .The results from logistic regression were summarized using the area under the ROC curve(AUC) .The pulsation index has been found hav-ing moderate judgment ability(P=0.016) for the dysfunction of grafts after CABG for one-year with optimal cut-off value of 2. 45.Conclusion Intraoperative high value of PI is the independent risk factor in patency rate of vessel grafts for one-year after CABG.
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Objective: To review the experience of using the transit time flow measurement(TTFM) in coronary artery bypass grafting(CABG). Methods: From Sept.2001 to May, 2002,90 cases underwent CABG. Among them, 40 cases with off-pump beating heart (OPCAB) and 50 with conventional coronary bypass grafting. All graft patency were verified intraoperatinlly with TTFM. The flow value of left internal mammary artery (LIMA) in 30 cases was also detected by the same way before grafting to left anterior descending (LAD). Results: There was no operative death and severe complications. The mean flow value of LIMA in 30 cases was (42.9?33.0)ml/min. The actual blood flow value, measured simultaneously by exsanguination was (37.4?28.8)ml/min. Excellent correlation was demonstrated. The mean pulsatility index value (PI) was 1.00?0.04. The flow curve showed both diastolic and systolic filling. The mean flow value of LIMA to LAD, saphenous vein graft (SVG) or radial artery (RA) to circumflex coronary artery (LCX) or diagonal (D), SVG or RA to right coronary artery (RCA) or post anterior artery (PDA) were (29.9?9.5)ml/min, (33.7?17.5)ml/min and (31.5?19.2)ml/min. The PI values were 2.47?0.88, 4.00?1.90 and 2.60?1.30, respectively. The typical flow curve was shown in all LIMA to LAD, and SVG (or RA) to LCX (or D). Blood flow filling was mainly during diastole with minimal systolic peaks during the isovolumetric ventricular contraction. SVG or RA to RCA presents a particular flow pattern characterized by a dual filling. 6 grafts were revised basing on unsatisfied flow curves, PI, and the mean flow or all of them. Significant technical error such as conduit kinking, stenosis of distal anastomosis was found. Conclusion: The patency of graft in CABG can be verified in intraoperatively by use of TTFM. The decision of checking or revising a graft can be made basing on parameters acquired from the TTFM device. To correctly analyze the parameters warrants good clinical results.
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0.05). However, we found that the proportions of low Qm (5) in the patients over 60 years were significantly higher than those in the patients younger than 60. [For low Qm, IMA: 13% (10/75) vs 2% (1/46), and GSV: 13% (33/259) vs 6% (7/123), ?2=4.296 and 4.422, P
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0.05]. Moreover, the Qm and PI of the grafted anterior descending, circumflex, and right coronary arteries were similar between the two groups.Conclusions No significant difference exists in the graft blood flow between OPCABG and CCABG groups.
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Cell DNA content in heart, liver, kidney of rats were analysed by flow cytometer at different postmortem interved. The rsults show that mean cellular DNA content is 99.5% at 6 hours, 91.3% at 12 hours, 87.1% at 18 hours, 81.3% at 24 hours, 76.7% at 30 hours, 74.3% at 36 hours, 72.3% 48 hours as compared with that at o hours The results ingicates that the quantitative determination of cell DNA in the tissues, mentioned above may provide an objective and reliable approach for the estimation of postmortem time.
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The phagocytosis of fluorescence microbeads by washed pulmanary marophages of rabbit was determined by the flow cytometry at different postmortem interval. The results showed that the phagocytosis of the pulmonary macrophages of rabbit was markadly dropped with time elapsed after death. It was shown that the rate of phagocytic cell and the number of fluorescence microbeads per cell were decreased along with the prolongation of time after death. This method is helpful to estimate the time of death.