Clinical study of graft-left anterior descending artery assessment in off-pump coronary artery bypass grafting with intraoperative epicardial echocardiography
10.3760/cma.j.issn.1004-4477.2017.11.008
- VernacularTitle:非体外循环下冠状动脉旁路移植术中心外膜超声评价左前降支桥血管的临床研究
- Author:
Lei ZHANG
1
;
Ran DONG
;
Qiang YONG
;
Haiming DANG
;
Yue SONG
;
Chao ZHENG
Author Information
1. 首都医科大学附属北京安贞医院综合超声科
- Keywords:
Echocardiography;
Coronary artery bypass,off-pump;
Left anterior descending artery;
Graft vessel
- From:
Chinese Journal of Ultrasonography
2017;26(11):947-952
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical value of intraoperative epicardial echocardiography ( IEE) in assessing graft-left anterior descending artery ( LAD ) of off-pump coronary artery bypass grafting ( OPCABG) . Methods IEE was used to detecte graft vessels anastomosis in 53 patients with OPCABG-LAD . Two-dimensional grey ultrasound and color Doppler ultrasound was used to show whether there was abnormal echo in proximal and distal lumen , measuring diameter and rate of stenosis . Pulse Doppler ultrasound was used to observe the blood flow spectrum . Intraoperative transient blood flow meter (TTFM) was employed to measure the pulsatility index and flow volume . Results Among the 53 patients with OPCABG-LAD ,38 cases were left internal mammary artery graft (LIMA) ,15 cases were saphenous vein graft (GSV) . Pulsatility index and flow volume showed normal by TTFM . The detection rates of graft vessels-LAD anastomosis in proximal and distal segment were 100％ using IEE , including 10 cases anastomotic plaques and 10 cases proximal plaques . Comparison of blood flow parameter of graft by IEE and TTFM in operation ,there was no significant difference in LIMA grafts ( P =0 .091) ,but the correlation was statistically significant ( r = 0 .809 , P < 0 .001 ) ;the difference in GSV grafts had no statistical significance ( P = 0 .821 ) ,but the correlation was statistically significant ( r = 0 .684 , P = 0 .005 ) . Conclusions IEE clearly displays the lumen of graft vessel and LAD ,and measures the hemodynamic indexes . It provides an intuitive ,accurate and convenient method for detecting the patency of the graft vessels during OPCABG .
