CABG Guidebook 2

10. Suboptimal TTFM curves Twisted or kinked graft Gratts that are twisted or kinked Will give disorganized TTFM curves that have low flow and often high spikes and high Pl. Questionable TTFM in RA-OM on- pump, Low flow, Pl over (Kieser recommends on-pump and a jagged low curve.6 ACI is bw. but acceptable. The gratt was redone as the vessel had a 360 degree twist. Post revision TTFM shown on page 46. LIMA-LAD TTFM pre protamine with low flow and high Pl. DF is also low. The systolic Spikes indicate flow obstruction. The graft was shortened by approximatety 1 cm and the incision in the LAD was extended. Flow improved after revision. Poor TTFM due to slightly kinked graft. Native coronaries went in and out of spasm, probably affecting the TTFtv1 parameters. The graft was shortened and TTFM improved.