Coronary Artery Bypass Grafting surgery, also known as CABG, is a common surgical procedure to treat coronary artery disease, relieve angina, limit the progression of ischemic heart disease and increase life expectancy.
A successful surgical outcome from CABG directly depends on well-functioning grafts. Early graft failures are a well-recognized clinical problem affecting some 10% of CABG patients or more. An intra-operative graft patency test, Transit Time Flow Measurement or TTFM (Medistim ASA, Norway) is recommended to ensure surgical success and to limit potential risks, such as peri- or post-operative infarction, haemodynamic instability, prolonged hospital stay and a failure to alleviate the presurgical symptoms of the coronary artery disease.
In 2010, 2014 and 2108, ‘The European Guidelines on Myocardial Revascularization’ jointly issued by the European Society of Cardiology (ESC) and European Association of Cardio-Thoracic Surgeons (EACTS) have recommended the routine use of TTFM to identify and correct imperfect bypass grafts prior to chest closure. However only some 30% of the 800,000 CABG procedures world-wide annually are currently being objectively assessed for graft patency and only 20% of CABG procedures in the United States. (Ref: Ann Cardiothorac Surg. 2018 Sep; 7(5): 652–662.; and J Card Surg. 2021;1–4.)
Medistim ASA (Norway), the leading supplier of TTFM and ultrasound imaging technologies, appointed Pacific Medical Systems Limited (Hong Kong) in 2004 as its exclusive distribution partner for Greater China and South East Asia.
“We have been working closely with local KOL’s and reference centres, our distribution partners and specialists in China and the Region, to create and drive the necessary awareness. As a result, a continuous increase in clinical acceptance and national adoption rates for using the Medistim Intra-operative graft patency verification technology has been noted. Tracking the Medistim system installations, the TTFM probe deliveries and the annual CABG surgical numbers such as those published in the ‘White Book of Chinese Cardiovascular Surgery and Extracorporeal Circulation” (ref: ChSECC), a penetration rate for using the Medistim TTFM graft function assessment in China of over 70% can be estimated. This means China has now one of the World’s highest adoption rates for using a routine, objective graft quality assessment in CABG surgery. Meanwhile, in Hong Kong and Singapore, the use of Medistim has been the standard of care for some time, a trend that is increasingly present in Taiwan and other parts of South East Asia where some 50% of all CABG’s are assessed with TTFM prior to chest closure,” says Jules Flach, Founder and CEO of Pacific Medical Systems Limited.
Using Medistim to assess the graft patency as a final check before finishing the procedure is now a standard routine in many CVS centres that are performing CABG surgery in China, including the 10 highest volume centres as listed by ChSECC in the 2021 report, Beijing Fuwai Hospital, Beijing Anzhen Hospital, Wuhan Asian Heart Hospital, Shanghai Zhongshan Hospital, Guangdong Institute of Cardiovascular Diseases, Xi Jing Hospital, Wuhan Union Hospital, Fuwai Central China Cardiovascular Hospital, No.1 Affiliated Hospital of Zhengzhou University and Xiangya No. 2 Hospital.
Learn more about Medistim: