Transit Time Flow Measurement in Coronary Surgery
NCT Number: NCT06471062
Acronym: COLLATERAL
Status: NOT_YET_RECRUITING
Study Type: OBSERVATIONAL
Conditions: Coronary Artery Disease|Coronary Stenosis|Coronary Bypass Graft Stenosis
Sponsor: Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 135
Study Design: Observational Model: |Time Perspective: p
Start Date: 2024-07-20
Completion Date: 2025-10-20
Locations: Fondazione Policlinico Gemelli IRCCS, Roma, Italy

Summary:
Transit-time flowmetry (TTFM) allows grafts quality control during coronary artery bypass surgery by measuring the flow volume through them.

To date, many studies have deeply studied the predictive role on the graft outcomes of the various flowmetry-derived parameters. One of the least investigated aspects, however, is the mutual influence that two newly realized grafts can have. This possibility would be related to the presence of a more or less developed collateral circulation between the bypassed territories.

The purpose of this study is to assess whether a graft for a territory different than that provided by the left anterior descending artery (LAD) may affect the functionality (measured through flowmetry) of the left internal mammary artery - LAD graft.

Primary Outcome Measures: LIMA>LAD Pulsatility index (PI) modification, The primary aim of this study is to assess whether a graft for a non-LAD coronary target modifies the performance (measured by flowmetry) of the flow in the LIMA\>LAD graft.

PI is expressed by the ratio of the flow volume amplitude and mean flow volume, both quantified by a flowmeter (ml/min / ml/min). An ideal value would be \&lt; 3, During the surgery, out of cardiopulmonary bypass
Secondary Outcome Measures: LIMA>LAD mean flow change, under rest conditions and after pharmacological stress. The unit of measure will be ml/min. The average flow should be above 20 ml/min., During surgery, before and after transient occlusion of the other grafts for non-LAD coronary targets|LIMA>LAD Diastolic filling (%DF) change, under rest conditions and after pharmacological stress. The unit of measure will be the ratio between two parameters expressed by ml/min., During surgery,before and after transient occlusion of the other grafts for non-LAD coronary targets.|variation of Diastolic filling (%DF) on the right coronary, depending on its dominance or hyperdominance. The unit of measure will be the ratio between two parameters expressed by ml/min. DF% is accepted around 50%., During surgery,before and after transient occlusion of the other grafts for non-LAD coronary targets.|LIMA>LAD % Backward flow (BF) change, under rest conditions and after pharmacological stress. The unit of measure will be the ratio between two parameters expressed by ml/min. The identified cut-off is 3% of the total flow., During surgery, before and after transient occlusion of the other grafts for non-LAD coronary targets.|mean flow, Pulsatility Index, Diastolic filling (%DF) and Diastolic filling (%DF) in the non-LAD grafts, under rest conditions and after pharmacological stress. The meaf low will be measured in "ml/min". The others will be expressed by the ratio between two parameters expressed by ml/min., During surgery, before and after transient occlusion of the LIMA>LAD graft