Document Detail

Transesophageal Doppler echocardiographic detection of intramyocardial collateral flow to the right coronary artery and changes in the flow to the inferior left ventricular wall immediately after coronary artery bypass grafting.
MedLine Citation:
PMID:  17145215     Owner:  NLM     Status:  MEDLINE    
This study examined the feasibility of Doppler transesophageal echocardiography (TEE) to detect collateral flow to the myocardium supplied by the right coronary artery (RCA) in the inferior left ventricular wall. Forty-four patients who underwent elective coronary artery bypass grafting (CABG) were prospectively studied. Presence of collateral flow to the RCA was diagnosed on preoperative angiography using the Rentrop score and by intraoperative Doppler TEE. Agreement of the 2 methods was analyzed by calculating the kappa coefficient. Collateral flow was present on preoperative angiography in 19 patients and absent in 25 patients. Intraoperative TEE detected collateral flow in the inferior wall in 15 patients (79%) with and 3 patients (12%) without angiographic collaterals, resulting in a kappa coefficient for agreement of 0.67 (95% confidence interval 0.45 to 0.90). Baseline collateral flow disappeared after CABG in 12 of 14 patients with grafting of the RCA but persisted in all patients without such grafting. Physiologic flow in the inferior wall was detected by TEE in a total of 27 patients at baseline and in 38 patients after CABG (p = 0.0018); its peak velocity increased after surgery only in the subgroup of patients with grafting of the RCA. In conclusion, these findings indicate that Doppler TEE may detect collateral flow in the inferior left ventricular wall, and that there are typical changes in collateral and physiologic flow after CABG.
Jianwen Wang; Miodrag Filipovic; Karl Skarvan; Isabelle Michaux; Regina Schumann; Peter Buser; Manfred D Seeberger
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-10-18
Journal Detail:
Title:  The American journal of cardiology     Volume:  98     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-05     Completed Date:  2007-01-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1587-92     Citation Subset:  AIM; IM    
Department of Anesthesia, University Hospital of Basel, Basel, Switzerland.
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MeSH Terms
Aged, 80 and over
Blood Flow Velocity
Collateral Circulation*
Coronary Angiography
Coronary Artery Bypass*
Coronary Circulation*
Echocardiography, Doppler*
Echocardiography, Transesophageal*
Middle Aged

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

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