| Evaluation of flow characteristics of the left internal thoracic artery graft: perioperative color Doppler ultrasonography versus intraoperative free-bleeding technique. | |
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MedLine Citation:
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PMID: 15745288 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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From October 2000 through April 2001, we prospectively evaluated the flow characteristics of the left internal thoracic artery (LITA) graft in a homogenous group of 44 men with isolated severe proximal left anterior descending coronary artery stenosis who underwent elective coronary artery bypass grafting with cardiopulmonary bypass. We performed transthoracic color Doppler ultrasonography preoperatively and repeated this examination in each patient between the 5th and 7th postoperative days, obtaining cross-sectional area, total flow volume, diastolic velocity, systolic velocity, mean velocity, pulsatility index, and resistance index. These results were compared with those of the intraoperative free-bleeding technique. Good-quality Doppler images of the LITA were easily obtained with a combined supraclavicular-parasternal approach. After surgery, systolic flow velocity, pulsatility index, and resistance index decreased significantly, but diastolic flow velocity and mean flow velocity increased significantly. The intraoperative flow volume obtained by the free-bleeding technique (32.42 +/- 12.33 mL/min) was significantly less than both pre- and postoperative ultrasonographic values (42.22 +/- 10.77 mL/min and 45.36 +/- 19.52 mL/min, respectively). No significant difference was found when changes in LITA values were compared between patients with (n=19) and without (n=25) normal anterior wall motion. We conclude that color Doppler ultrasonography is a reliable noninvasive technique for preoperative evaluation of the LITA as a graft and for postoperative long-term follow-up of graft function. However the intraoperative free-bleeding technique is not reliable for flow-volume measurement due to anesthesia-related hemodynamic changes and vasospasm. Color Doppler can prevent useless LITA harvesting and decrease the need for postoperative LITA angiography. |
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Authors:
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Kerim Cagli; Mustafa Emir; Aysegul Kunt; Kumral Ergun; Tola Muharrem; Topbas Murat; Kerem Vural; Erol Sener |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital Volume: 31 ISSN: 0730-2347 ISO Abbreviation: Tex Heart Inst J Publication Date: 2004 |
Date Detail:
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Created Date: 2005-03-04 Completed Date: 2005-03-24 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 8214622 Medline TA: Tex Heart Inst J Country: United States |
Other Details:
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Languages: eng Pagination: 376-81 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery, Yuksek Ihtisas Hospital, Ankara, Turkey. kerimcagli@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Blood Flow Velocity / physiology Coronary Artery Bypass* Coronary Artery Disease / physiopathology, surgery*, ultrasonography Coronary Circulation / physiology* Female Hemorheology Humans Male Mammary Arteries / physiopathology*, transplantation, ultrasonography Middle Aged Monitoring, Intraoperative Postoperative Period Pulsatile Flow / physiology Ultrasonography, Doppler, Color* Vascular Resistance / physiology |
| Comments/Corrections | |
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