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Asian Cardiovasc Thorac Ann 2003;11:143-146
© 2003 Asia Publishing EXchange Ltd

ORIGINAL CONTRIBUTIONS

Intravascular Ultrasound: Potential Tool to Assess Coronary Anastomosis Quality

Piergiorgio Tozzi, MD, Antonio F Corno, MD, Ludwig K von Segesser, MD

Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

For reprint information contact: Piergiorgio Tozzi, MD Tel: 41 21 3142280 Fax: 41 21 3142278 email: tozzig{at}hotmail.com Service de Chirurgie CardioVasculaire - BH10, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon, 46,1011–Lausanne, Switzerland.

Coronary angiography and Doppler flow measurements are most commonly used to assess the patency of anastomoses in the operating theater. Intravascular ultrasound might be another means of monitoring the surgical procedure during coronary artery bypass. Five sheep underwent off-pump bypass of the left anterior descending coronary artery using the left internal mammary artery. The running suture was evaluated by intraoperative fluoroscopy and a coronary intravascular ultrasound probe inserted into the target artery proximal to the anastomosis. Macroscopic examination of the anastomosis was performed to validate the angiographic and intravascular ultrasound images. The diameter, cross-sectional area, and compliance of each anastomosis were calculated in systole and diastole. All anastomoses were patent without signs of stenosis. In one case, intravascular ultrasound showed an intimal flap, which was confirmed by macroscopic examination. The mean major anastomotic diameter was 4.5 ± 0.5 mm on angiography and 4.0 ± 0.5 mm on intravascular ultrasound. From the ultrasound data, the mean cross-sectional anastomotic area was calculated as 6.21 ± 0.1 mm2 in systole and 5.49 ± 0.1 mm2 in diastole, and these data were used to calculate the cross-sectional anastomosis compliance. Coronary intravascular ultrasound can visualize intima-to-intima apposition and provide reliable calculations of anastomosis compliance.




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T. C. Dessing, R. P.J. Budde, R. Meijer, P. F.A. Bakker, C. Borst, and P. F. Grundeman
Geometry assessment of coronary artery anastomoses with construction errors by epicardial ultrasound
Eur. J. Cardiothorac. Surg., August 1, 2004; 26(2): 257 - 261.
[Abstract] [Full Text] [PDF]


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