Assessment of Left Internal Mammary Artery Grafts Using Dipyridamole Doppler Echocardiography

Pezzano, Antonio; Fusco, Rossana; Child, Maurice; Riccobono, S.; Milazzo, Angela; Recalcati, F; Savonitto, Stefano

doi:10.1016/s0002-9149(97)00775-3

Cited by 24 publications

(23 citation statements)

References 13 publications

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“…All CDUSG examinations were performed by same trained and experienced radiologist. CDUSG was performed through supraclavicular space while the patient was in supine position (4)(5)(6). After 15 minutes of resting at supine position, the duplex probe was placed directly on the skin after application of a commercial ultrasonic gel.…”

Section: Study Population and Protocolmentioning

confidence: 99%

“…A non-invasive method of assessment would be useful in this group of patients. Color Doppler ultrasonography (CDUSG) has been studied widely for the assessment of LITA graft patency previously (4)(5)(6)(7)(8)(9). In these studies, the primary parameter that shows the graft functionality was the ratio of peak flow velocities during diastolic and systolic period.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of Doppler ultrasonography for assessment of internal thoracic artery graft patency

Yay

Boysan²,

Ünal³

et al. 2014

Anadolu Kardiyol Derg

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Objective: The main purpose of this study was to assess the patency of left internal thoracic artery (LITA) graft by using color Doppler ultrasonography (CDUSG) and furthermore to determine the sensitivity and specificity of CDUSG for patency by using coronary angiography as the reference standard. Methods: This study is an observational cohort study on diagnostic accuracy that was held between August 2008 and October 2009. CDUSG was performed in 138 consecutive patients who had angina symptom or positive ischemic findings following coronary artery bypass surgery. LITA blood flow velocity at peak-systole (PSV), diastole (PDV) and end-diastole (EDV) was recorded. All patients were also assessed by coronary angiography for LITA graft patency. Statistical analysis was performed by using independent samples t-test, Mann-Whitney-U test, chisquare test and receiver operating curve analyses (ROC). Results: Seventy-eight of all patients had functional LITA grafts and 59 patients had dysfunctional LITA grafts according to CDUSG-derived parameters, whereas we cannot conclude about one patient's LITA graft functionality. The LITA grafts were visualized angiographically in all cases. Of all 138 patients, 60 patients had dysfunctional LITA grafts after angiographic evaluation. The ROC analyses showed that PDV (AUC=0.899, 95% CI 0.844 to 0.953; p<0.001) and EDV (AUC=0.900; 95% CI 0.847 to 0.953; p<0.001) values were also strongly associated with graft functionality. We found out that CDUSG predicts LITA graft functionality with a sensitivity and specificity of 100% and 98.4% respectively. The accuracy of the CDUSG was calculated as 99.3%. Conclusion: CDUSG is a reliable non-invasive method for assessment of LITA graft patency. (Anadolu Kardiyol Derg 2014; 14: 286-91)

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Section: Study Population and Protocolmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of Doppler ultrasonography for assessment of internal thoracic artery graft patency

Yay

Boysan²,

Ünal³

et al. 2014

Anadolu Kardiyol Derg

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“…Dipyridamole stress testing is frequently used in this setting for the evaluation of angina and graft flow (14)(15)(16)(17). This test studies the grafts in vivo.…”

Section: Discussionmentioning

confidence: 99%

The Evaluation Of In Vitro Effects Of Dipyridamole On Coronary Artery Bypass Grafts

Ege¹,

Karaca²,

Gür³

et al. 2010

TUTFD

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Objective: The aim of this study is to evaluate the efficacy of dipyridamole in relieving the vasospasm of coronary artery bypass grafts.Material and Methods: Twenty two patients who underwent elective coronary artery bypass grafting (CABG) were admitted to the study (Men/Women:14/8, mean age: 62.4±8.8 years). Ten samples from left internal mammary(LIMA), radial arterial (RA) and saphenous vein (SV) grafts were collected for each. The samples were transported to the vascular laboratory in 4°C Krebs solution. Submaximal smooth muscle contraction was achieved first by 10-7M of phenylephrine solution. Dipyridamole was then added, starting from a concentration of 10-9M to a concentration of 10-3.5M in two minutes intervals and half logarithmic dose increments. The concentration-response curves were obtained of the vasodilatation response relative to the begining.Results: In the LIMA graft samples, the vasodilation response to dipyridamole was 43.2±1.6% and 97.6±4.1% at concentrations of 10-6M and 10-3.5M respectively. In RA graft samples, the vasodilation response to dipyridamole was 36.3±1.8% and 95.3± 2.7% at concentrations of 10-6M and 10-3.5M respectively. In SV graft samples, however, the vasodilation response to dipyridamole was 43.2±1.4 % and 96.6± 2.2% at concentrations of 10-6M and 10-3.5M respectively. Conclusions:The amplitude of relaxation response to dipyridamole of all grafts samples were similar, without statistically significant difference among the IMA, RA and SV grafts in the in vitro tissue bath system. These results prove that dipyridamole has a potential use as a vasodilatatory drug in all graft types.

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“…There are controversies regarding some variables measured by Doppler, but the integral of the mean velocity/time (VTI) is well accepted as an indicator of patency [6][7][8][9][10][11][12][13].…”

Section: Dvti = Diastolic Average Velocity-time Integral; Df = Diastomentioning

confidence: 99%

“…Using these recorded measurements, the flow reserve can also be measured by comparing flow under stress to flow at rest [13].…”

Section: Introductionmentioning

confidence: 99%

Doppler echocardiographic criteria in patency assessment of composite grafts from left internal thoracic artery

Leitão¹,

Filho²,

Freire³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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Rev Bras Cir Cardiovasc | Braz J Cardiovasc SurgRev Bras Cir Cardiovasc 2013;28(2):167- Abstract Objectives The purpose of our study was to establish, with an entirely noninvasive method, transthoracic Doppler echocardiography, criteria for patency of composite left internal thoracic artery grafts when placed on the left anterior descending artery and other branches of the left coronary system.Methods: The control group comprised 20 patients with single graft and 20 patients with composite graft; all forty having their patency confirmed by coronary angiogram (CA). In this control group, two Doppler echocardiographic variables, diastolic mean velocity-time and integral diastolic peak velocity to systolic peak velocity ratio were recorded. For each variable, established cut-off points were established, using the ROC (Receiver Operator Characteristic) curves, to identify criteria which could differentiate the composite grafts. Only patients with composite grafts were included in the 159-patients study group. The criteria established by the cut-off points in the control group were then applied to detect patency using a diastolic fraction of ≥ 0.5 as the gold standard. The sensitivity, specificity, and positive and negative predictive values of these two criteria were determined.Results: In the control group, cut-off points of 0.71 and 0.09m were established for the diastolic peak velocity/systolic peak velocity ratio and for diastolic mean velocity-time integral, respectively. In the study group phase, the sensitivity and negative predictive value of the diastolic peak velocity/systolic peak velocity ≥ 0.71 criterion were 36% and 11%, respectively. Diastolic mean velocity-time integral ≥ 0.09m criterion, were 40% and 10.48%. The specificities and positive predictive values of each criterion were 100%. ORIGINAL ARTICLE 168Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg

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Assessment of Left Internal Mammary Artery Grafts Using Dipyridamole Doppler Echocardiography

Cited by 24 publications

References 13 publications

Diagnostic accuracy of Doppler ultrasonography for assessment of internal thoracic artery graft patency

Diagnostic accuracy of Doppler ultrasonography for assessment of internal thoracic artery graft patency

The Evaluation Of In Vitro Effects Of Dipyridamole On Coronary Artery Bypass Grafts

Doppler echocardiographic criteria in patency assessment of composite grafts from left internal thoracic artery

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