Document Detail


Transthoracic Doppler echocardiography of mammary artery grafts to assess graft function.
MedLine Citation:
PMID:  15685302     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Transthoracic Doppler echocardiography of internal mammary artery grafts (MAGs) has been tested by the supraclavicular approach, but little information is available about the parasternal approach. OBJECTIVE: To evaluate the usefulness of parasternal transthoracic Doppler echocardiography to assess the patency of left and right MAGs. PATIENTS AND METHODS: Forty-eight patients with previous MAGs were divided into two groups on the basis of coronary angiography: 42 patients had patent MAGs and six patients had severe MAG stenosis. Doppler echocardiography of MAGs was performed on all patients, both at baseline and after low-dose dipyridamole infusion. Systolic and diastolic time-velocity integrals and their ratios were obtained, and MAG flow reserve was calculated. RESULTS: Patients with patent MAGs had a predominant diastolic flow, while a prominent systolic pattern was found in the presence of MAG stenosis. In patients with stenosis, baseline Doppler analysis showed a lower diastolic peak velocity (DPV) (P<0.01), diastolic time-velocity integral (P<0.05), and diastolic and systolic time-velocity integral ratios (both P<0.005), and a reduced MAG flow reserve (P<0.001). In the overall population, when adjusting for clinical variables, a multilinear regression analyis underscored MAG flow reserve (beta=0.38, P<0.01) and baseline DPV (beta=0.29, P<0.05) as independent determinants of MAG stenosis (cumulative R2=0.25, P<0.005). CONCLUSIONS: Doppler echocardiographic evaluation of MAGs is a reliable, noninvasive tool to assess MAG patency and functional status of the vessel. MAG blood flow reserve and baseline DPV are independent determinants of MAG stenosis.
Authors:
Silvana Cicala; Attilio Renzulli; Maurizio Galderisi; Luigi De Simone; Marisa De Feo; Francesco Onorati; Flavio Cerasuolo; Giulio Bonzani; Pio Caso; Maurizio Cotrufo
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  21     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-02-01     Completed Date:  2005-03-31     Revised Date:  2008-04-09    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  45-9     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Monaldi Hospital, Naples, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cohort Studies
Coronary Artery Bypass / adverse effects,  methods*
Coronary Disease / surgery*,  ultrasonography*
Echocardiography, Doppler, Color
Echocardiography, Transesophageal*
Female
Graft Rejection
Graft Survival
Humans
Internal Mammary-Coronary Artery Anastomosis
Linear Models
Male
Middle Aged
Monitoring, Physiologic / methods
Postoperative Complications / ultrasonography
Probability
Prognosis
Risk Assessment
Sensitivity and Specificity
Statistics, Nonparametric
Vascular Patency

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


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