Color-flow duplex ultrasound assessment of internal thoracic artery graft after coronary bypass

Canver, Charles C.; Armstrong, Victoria M.; Nichols, Ronald; Mentzer, Robert M.

doi:10.1016/0003-4975(94)00842-u

Cited by 19 publications

(10 citation statements)

References 7 publications

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“…Despite accurate and reliable assessment of native LITA before CABG, we cannot succeed to identify in situ LITA graft accurately after CABG at initial. This is partly because of unfavorable chest wall configuration, coexistent lung diseases and the learning curve experience (25 et al (26) stated that obtaining LITA graft non invasively with the transthoracic approach is difficult because of its narrow lumen and constant pulsatile movement. Therefore they evaluated the LITA graft flow with echo Doppler from the supraclavicular approach because the proximal part of the LITA graft is close to the chest wall and fixed with soft tissue and hence free from pulsatile displacement.…”

Section: Discussionmentioning

confidence: 99%

“…All our LITA CDUSGs were performed by the same radiologist. Canver et al (25) reported that after trying numerous postoperative imaging studies with CDUSG they reached a rate over 90% while visualizing LITA grafts and suggest that changes in LITA graft flow dynamics may offer the clinician to identify graft failure. Postoperative color Doppler ultrasonographic LITA studies revealed significant changes from preoperative data.…”

Section: Discussionmentioning

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: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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“…Normal arterial Doppler signals are usually biphasic or triphasic. 3 The first component corresponds to the high velocity forward flow, which occurs during systole, that is, peak systolic velocity. The second is of a lower frequency than the first and corresponds to reversed flow in early diastole, that is, enddiastolic velocity.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Left Internal Mammary Artery Graft Patency by Transthoracic Doppler Echocardiography

Elmasry

Salama

Darwish

et al. 2002

Clinical Cardiology

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SummaryBackground: The successful application of noninvasive Doppler spectrum analysis has been reported for the hemodynamic assessment of LIMA graft after myocardial revascularization.Hypothesis: The objective of this study was to assess the utility of transthoracic Doppler echocardiography (TTE) in providing information on LIMA flow in patients after coronary artery bypass graft surgery.Methods: In all, 22 patients (aged 62 ± 8 years) with LIMA graft to the left anterior descending (LAD) coronary artery who underwent coronary angiography were assessed using high-frequency (5 MHz) transthoracic Doppler echocardiography. They were compared with 25 patients with angina (control group A, aged 59 ± 12 years), in whom an ungrafted LIMA was assessed, and with 17 patients (control group B, aged 59 ± 9 years) with angiographically normal coronary arteries, in whom the LAD was assessed.Results: A biphasic pattern (systolic and diastolic) was recorded in all cases. In 14 patients with a normal graft or < 70% stenosis (Group 1) and in control group B, blood flow was maximal during diastole. In eight patients with severe graft stenosis > 70% (Group 2) and control group B, blood flow was maximal during systole, with low diastolic flow. The diastolic fraction of the velocity time integrals was 0.81 ± 0.11 for Group 1 and 0.25 ± 0.06 for Group 2 (p < 0.05). A diastolic velocity time integral fraction < 0.5 predicted > 70% stenosis

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“…Normal arterial Doppler signals are usually biphasic or triphasic [8]. The first component corresponds to the high velocity forward flow, which occurs during systole, that is, peak systolic velocity (PSV).…”

Section: Coronary Circulation Physiopathology and Doppler Flow Characmentioning

confidence: 99%

Transthoracic Doppler echocardiography of the left internal mammary artery graft

Parv¹

2013

Med Ultrason

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Assessment of the left internal mammary artery (LIMA) graft patency currently requires invasive investigation through coronary angiography. In the last years the successful application of noninvasive Doppler spectrum analysis has been reported for patency assessment of the LIMA graft after myocardial revascularization. Echocardiography is considered to be a sensitive noninvasive screening modality to diagnose critical narrowing of LIMA grafts and angiography should be reserved for cases in which Doppler echocardiography fails to visualize the LIMA or reveals an abnormal flow pattern.

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Color-flow duplex ultrasound assessment of internal thoracic artery graft after coronary bypass

Cited by 19 publications

References 7 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

Assessment of Left Internal Mammary Artery Graft Patency by Transthoracic Doppler Echocardiography

Transthoracic Doppler echocardiography of the left internal mammary artery graft

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