Doppler Flowmeter Is a Valuable Tool for Prevention of Early Postoperative Myocardial Infarction

Ahmed  M Abdelazim; Mahmoud M Abdel Azeem Mubarak

Ahmed M Abdelazim Department of Cardiothoracic Surgery, Banha University Hospitals, Banha, Egypt
Mahmoud M Abdel Azeem Mubarak Department of Cardiothoracic Surgery, Banha University Hospitals, Banha, Egypt

Keywords: Doppler flowmetry, Coronary artery bypass grafting, Perioperative myocardial infarction, Clinical trials

Abstract

Background: Early postoperative myocardial infarction (MI) remains a critical complication following coronary artery bypass grafting (CABG). The intraoperative use of Doppler flowmetry could improve outcomes by ensuring optimal graft patency and flow. This study evaluated the effect of Doppler flowmetry on early postoperative MI in patients undergoing CABG.

Methods: This double-blinded, randomized controlled study included 120 patients who underwent elective CABG. Patients were divided into two equal groups: Group A underwent CABG with Doppler flowmetry, and Group B underwent CABG without Doppler flowmetry. The patients' ages ranged between 45 and 60 years old, with no difference in gender distribution between groups. The primary outcomes were early postoperative arrhythmias and echocardiographic parameters. Secondary outcomes included mechanical ventilation duration, ICU stay, and complication rates.

Results: There was no difference in postoperative arrhythmias between groups (P= 0.142). Postoperative regional wall motion abnormalities occurred in 90% of Group B versus 5% of Group A (P < 0.001). Difficult weaning (10 (16.7%) vs. 25 (41.7%); P= 0.003), longer ventilation time (8 ±3 vs. 17 ±7 h; P<0.001), and prolonged ICU stay (3 (3 – 10) vs. 5 (2 – 9) days; P<0.001) were all significantly higher in Group B than that of group A. Infection and re-exploration rates were significantly higher in Group B (13.3% and 25%) than in Group A (1.7% and 6.7%) (P = 0.032 and P = 0.006, respectively). The cross-clamp time and total circulatory time were shorter in Group A (55 ± 6 minutes and 87 ± 12 minutes) than in Group B (89 ± 12 minutes and 110 ± 17 minutes) (P < 0.001). Multivariable logistic regression indicated that using Doppler flowmetry reduced the risk of reexploration by 81% (OR: 0.189, 95% CI:0.054 – 0.663, P= 0.009). There was no early mortality in both groups

Conclusion: Using Doppler flowmetry during CABG could improve intraoperative and postoperative outcomes, reducing perioperative myocardial infarction and related complications. This technique could be valuable to standard CABG procedures, enhancing patient recovery and reducing hospital stay duration.