Document Detail


Detection of patency of internal mammary artery grafts to the left anterior descending artery by transthoracic Doppler echocardiography.
MedLine Citation:
PMID:  16999692     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To determine whether a coronary artery bypass graft (CABG) is patent, we examined the flow of the left internal mammary artery (LIMA) to the left anterior descending artery (LAD) by transthoracic Doppler echocardiography (TTDE). PATIENTS AND METHODS: Eighty-seven patients with CABG (LIMA to distal LAD) were enrolled in the study. The flows from each subject were analyzed by three criteria: mosaic flow at the anastomosis site, distal anterograde flow (ante flow), and proximal retrograde flow (retro flow). RESULTS: On angiography, 79 grafts were patent and eight were not. TTDE study of 79 patent grafts demonstrated mosaic, ante, and retro flow in 63 (79.7%), 74 (93.7%), and 35 grafts (49.4%), respectively. The averaged diastolic peak velocity of ante flow was 26.3 +/- 11.0 cm/sec, significantly higher than that (4.8 +/- 7.1 cm/sec, P < or = 0.0001) in eight patients without patent grafts. These eight patients had no mosaic or retro flow and only three had ante flow. The accuracies to predict patency were 81.6%, 90.8%, and 49.4% for mosaic, ante, and retro flows, respectively. CONCLUSIONS: The existence of mosaic, retro, or sufficient ante flows strongly indicated the patency of LIMA to the LAD. When symptoms are possible to be derived from the occlusion of CABG to LAD, TTDE is a promising method to examine whether a LIMA to LAD bypass is patent.
Authors:
Hiromi Tasaki; Kazuhito Yamashita; Noriko Hirakawa; Hiroshi Suzuka; Tsuyoshi Morishita; Masahiro Okazaki; Yasuhide Nakashima; Ichiro Nagano
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  23     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-26     Completed Date:  2007-05-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  741-9     Citation Subset:  IM    
Affiliation:
Second Department of Internal Medicine and Division of Cardiovascular Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishku, Kitakyushu 807-8555, Japan. h-tasaki@med.uoeh-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / diagnosis,  physiopathology,  surgery
Blood Flow Velocity
Confounding Factors (Epidemiology)
Coronary Angiography
Coronary Circulation
Coronary Stenosis / diagnosis,  physiopathology,  surgery
Coronary Vessels / physiopathology*,  transplantation,  ultrasonography*
Echocardiography, Doppler*
Female
Graft Occlusion, Vascular / diagnosis*,  epidemiology,  etiology,  physiopathology
Heart Failure / diagnosis,  physiopathology,  surgery
Humans
Image Processing, Computer-Assisted
Internal Mammary-Coronary Artery Anastomosis*
Male
Mammary Arteries* / physiopathology,  radiography,  transplantation,  ultrasonography
Middle Aged
Myocardial Contraction
Risk Factors
Sensitivity and Specificity
Vascular Patency*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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