Original Title: Évaluation du débitmètre ultrasonique pour la vérification de la perméabilité des greffons lors des pontages aortocoronariens

Authors' objectives: Over the past 50 years, advances in technology and improved intraoperative care have reduced mortality and other complications resulting from coronary artery bypass graft (CABG) interventions. Graft failures in the year following surgery can be attributed to a technical error that could be corrected during the operation. In 2017 and 2018, the Department of Cardiac Surgery at the Quebec Heart and Lung Institute – Laval University (Institute) acquired two ultrasonic flowmeter devices to assess the patency of grafts during coronary revascularization surgeries. However, this supply of devices was not sufficient to meet the demand of all CABG interventions. The Professional Services Directorate of the Institute requested that the Health Technology Assessment Unit (HTAU) evaluate the relevance of improving access to ultrasonic flowmeters for the assessment of graft patency during coronary revascularization surgeries.

Authors' results and conclusions: Analysis of the body of evidence suggests that the flowmeter is safe and effective in identifying grafts requiring revision to reduce the risk of CABG failure. However, the effectiveness of the ultrasonic flowmeter in preventing postoperative cardiac events is unclear. Data from the literature did not identify specific indications for the use of this technology. Nevertheless, according to the majority of surgeons who responded to the survey, it is relevant for systematically assessing graft patency.

Authors' recommendations: According to the current state of knowledge, the HTAU recommends that cardiac surgeons at the Institute evaluate the patency of CABGs using an ultrasonic flowmeter. However, before purchasing additional devices, it will be necessary to carry out a field evaluation based on clinical data from the cardiac surgery database in order to determine the real clinical and budgetary impacts of this technology on the clientele of the institute. Clinical criteria for the evaluation of the patency of CABGs should be established by a consensus of experts made up of cardiac surgeons from the Multidisciplinary Department of Cardiology.

Project Status: Completed

URL for project: https://iucpq.qc.ca/fr/institut/qualite-et-performance/evaluation-des-technologies-et-modes-d-intervention-en-sante-etmis/accueil

Year Published: 2018

URL for published report: https://iucpq.qc.ca/sites/default/files/rap_debitmetre_ultrasonique_vf.pdf

Requestor: Professional Services Directorate

English language abstract: There is no English language summary available

Publication Type: Full HTA

Country: Canada

Province: Quebec

Organisation Name: Institut universitaire de cardiologie et de pneumologie de Québec – Université Laval (IUCPQ-ULaval)

Contact Address: 2725, chemin Sainte-Foy Québec QC G1V 4G5

Contact Name: uetmis.iucpq@ssss.gouv.qc.ca

Contact Email: uetmis.iucpq@ssss.gouv.qc.ca

Copyright: Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval