Noninvasive evaluation of internal thoracic artery and left anterior descending coronary artery anastomotic sites using transthoracic Doppler echocardiography: comparison with coronary arteriography
| Autor: | Takayoshi Ueno, Nobuaki Hirata, Shinichi Hatsuoka, Yoshio Kosakai, Akira Amemiya, Nobuaki Asaoka |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Duplex ultrasonography Internal thoracic artery Anterior Descending Coronary Artery Anastomosis Doppler echocardiography Coronary Angiography Internal medicine medicine.artery medicine Humans Derivation Coronary Artery Bypass Mammary Arteries Aged medicine.diagnostic_test business.industry Anastomosis Surgical Blood flow Middle Aged Coronary Vessels Echocardiography Doppler Bypass surgery Cardiology Female Surgery business Cardiology and Cardiovascular Medicine |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 126(4):1080-1086 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/s0022-5223(03)00812-2 |
| Popis: | Objectives This study was designed to evaluate anastomotic sites located between the internal thoracic artery and left anterior descending coronary artery using transthoracic Doppler echocardiography, and then to clarify the accuracy of those results by comparison with coronary arteriographic findings. Methods We examined 35 consecutive patients who had undergone bypass surgery. The echocardiographic examinations were performed within approximately 1 week of follow-up coronary arteriography, which occurred at 4.3 ± 2.2 months after bypass surgery. We measured the diameter using intraluminal flow signals, and we also measured flow velocity. Results Adequate spectral Doppler recordings of coronary flow in the anastomosis were obtained in 31 (89%) of the 35 study patients. In the normal anastomosis group (n = 25), the diameter and the peak blood flow velocity of the internal thoracic artery and left anterior descending coronary artery were 1.5 ± 0.3 mm and 2.0 ± 0.4 mm, and 58 ± 25 cm/s and 47 ± 20 cm/s, respectively. Stringed internal thoracic artery was found in 4 patients; the echocardiographic findings revealed a greater amount of information regarding the physiologic state in the area of anastomosis compared with angiographic findings. In a stenotic anastomosis found in 2 patients, the blood flow velocity findings at the anastomotic sites (83 ± 228 cm/s) were higher than those in normal anastomotic patients (59 ± 28 cm/s). Conclusions Transthoracic Doppler echocardiography enabled an effective evaluation of anastomotic sites between the internal thoracic artery and left anterior descending coronary artery in over 80% of our patients. This totally noninvasive method is thought to be reliable and able to provide a greater amount of information, compared with coronary arteriography, regarding the physiologic state of an anastomosis, such as a competitive relationship. |
| Databáze: | OpenAIRE |
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