Determination of coronary flow measurements by transesophageal echocardiography: Dependence of flow velocity reserve on the location of stenosis

Hutchison, Stuart J.; Soldo, Stephen J.; Gadallah, Sameh; Kawanishi, David T.; Chandraratna, P.A.N.

doi:10.1016/s0002-8703(97)70246-1

Cited by 18 publications

(6 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It allows assessment of ventricular function at the same time, as with the intraoperative transesophageal approach. 11 It can also process the color signals of 2 lines simultaneously, thereby providing a much higher frame rate. Unfortunately, it remains difficult to observe the full condition of the coronary arteries in the beating heart.…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Assessment by Epicardial Pulsed Doppler Ultrasound

Tedoriya

Siniawski

Tambeur

et al. 2001

Asian Cardiovasc Thorac Ann

View full text Add to dashboard Cite

An intraoperative method was developed for direct investigation of the coronary arteries using an epicardial high-frequency two-dimensional Doppler ultrasound transducer. This fingertip 7.5-MHz transducer was used in 30 patients undergoing coronary artery bypass surgery to measure blood flow in the coronary arteries and bypass grafts. In all the patients, clear images of the coronary arteries and the bypass grafts were obtained in the beating heart, and coronary blood flow could be measured to evaluate the degree of stenosis. There were no significant differences between the measurements obtained with the Doppler transducer and a transittime ultrasonic flowmeter of blood flow in the left internal thoracic artery graft to the left anterior descending coronary artery, indicating that the Doppler method produces accurate and reproducible measurements. This method can provide useful intraoperative information about the coronary artery system in emergency operations such as acute aortic dissection.

show abstract

Section: Discussionmentioning

confidence: 99%

Coronary Artery Assessment by Epicardial Pulsed Doppler Ultrasound

Tedoriya

Siniawski

Tambeur

et al. 2001

Asian Cardiovasc Thorac Ann

View full text Add to dashboard Cite

show abstract

“…27 Although Doppler transesophageal echocardiography has been used to estimate stenosis severity in the proximal LAD coronary artery, 28 it is associated with some patient discomfort (because it requires esophageal intubation), and localization of the Doppler sample volume distal to a stenosis or a major side branch is difficult. 29 Two-and 3-dimensional MRI techniques have been used to visualize coronary arteries, but relatively low spatial resolution (particularly when compared with contrast coronary angiography), 30 difficulty with algorithms used in reconstruction (for 3-dimensional techniques), 31 and MRI artifacts 32 have led to imprecise quantitation of stenosis severity. Using the gradient-echo techniques alone in this study, MRI investigators were able to identify stenosis location but not accurately determine stenosis severity.…”

Section: Discussionmentioning

confidence: 99%

Visualization and Functional Assessment of Proximal and Middle Left Anterior Descending Coronary Stenoses in Humans With Magnetic Resonance Imaging

et al. 1999

View full text Add to dashboard Cite

Background-Coronary artery bypass grafting improves survival in patients with Ͼ70% luminal diameter narrowing of the 3 major epicardial coronary arteries, particularly if there is involvement of the proximal portion of the left anterior descending (LAD) coronary artery. Measurement of coronary flow reserve can be used to identify functionally important luminal narrowing of the LAD artery. Although magnetic resonance imaging (MRI) has been used to visualize coronary arteries and to measure flow reserve noninvasively, the utility of MRI for detecting significant LAD stenoses is unknown. Methods and Results-Thirty subjects (23 men, 7 women, age 36 to 77 years) underwent MRI visualization of the left main and LAD coronary arteries as well as measurement of flow in the proximal, middle, or distal LAD both at rest and after intravenous adenosine (140 g/kg per minute). Immediately thereafter, contrast coronary angiography and when feasible, intracoronary Doppler assessments of coronary flow reserve, were performed. There was a statistically significant correlation between MRI assessments of coronary flow reserve and (a) assessments of coronary arterial stenosis severity by quantitative coronary angiography and (b) invasive measurements of coronary flow reserve (PϽ0.0001 for both). In comparison to computer-assisted quantitative coronary angiography, the sensitivity and specificity of MRI for identifying a stenosis Ͼ70% in the distal left main or proximal/middle LAD arteries was 100% and 83%, respectively. Conclusions-Noninvasive MRI measures of coronary flow reserve correlated well with similar measures obtained with the use of intracoronary Doppler flow wires and predicted significant coronary stenoses (Ͼ70%) with a high degree of sensitivity and specificity. MRI-based measurement of coronary flow reserve may prove useful for identification of patients likely to obtain a survival benefit from coronary artery bypass grafting. (Circulation. 1999;99:3248-3254.)

show abstract

“…Stress transesophageal echocardiography allows the evaluation of coronary blood flow velocity reserve of LAD. The CFR is reduced in patients with significant LAD disease, in case of proximal location or more severe stenosis, further impairment can be observed [5,[7][8][9][10][11]. When significant stenosis of right coronary artery and/or left circumflex coronary artery is associated, no further CFR impairment can be found [8].…”

Section: Discussionmentioning

confidence: 99%

Grade of Aortic Atherosclerosis: A Valuable Adjunct to Coronary Flow Velocity Reserve in the Evaluation of Coronary Artery Disease

Nemes

Thury

Forster

et al. 2007

Upsala Journal of Medical Sciences

View full text Add to dashboard Cite

Background: Atherosclerosis is a generalized disease of the arterial vasculature; among thus it manifests in the descending aorta and the coronary arteries. We tested whether known risk factors, the coronary flow velocity reserve and the grade of aortic atherosclerosis detected by transoesophageal echocardiography in the course of the same semi-invasive examination is able to distinguish between patients with significant left anterior descending coronary artery (LAD) stenosis or with multivessel disease.Methods and results: The present study involved 125 consecutive patients (mean age: 56 11 years, range: 22-73) with chest pain undergoing coronary angiography. Grade of aortic atherosclerosis was obtained by means of transoesophageal echocardiography, and the coronary flow velocity reserve was calculated in the left anterior descending coronary artery. The age (ROC area, 63%, p<0.01), the gender (ROC area, 63%, p<0.02) and the grade of aortic atherosclerosis (ROC area, 64%, p<0.01) exhibited good power for the prediction of patients with multivessel disease from among all other patients. Only the grade of aortic atherosclerosis (ROC area, 63%, p<0.05) appears useful to distinguish patients with left anterior descending coronary artery disease from those with multivessel disease.Conclusions: These results demonstrate that grade of aortic atherosclerosis furnishes additional help in the prediction of patients with severe coronary artery disease. It can differentiate patients with multivessel disease from those with significant left anterior descending coronary artery stenosis. Coronary flow velocity reserve has no any prognostic power in this evaluation. List of abbreviations

show abstract

Determination of coronary flow measurements by transesophageal echocardiography: Dependence of flow velocity reserve on the location of stenosis

Cited by 18 publications

References 17 publications

Coronary Artery Assessment by Epicardial Pulsed Doppler Ultrasound

Coronary Artery Assessment by Epicardial Pulsed Doppler Ultrasound

Visualization and Functional Assessment of Proximal and Middle Left Anterior Descending Coronary Stenoses in Humans With Magnetic Resonance Imaging

Grade of Aortic Atherosclerosis: A Valuable Adjunct to Coronary Flow Velocity Reserve in the Evaluation of Coronary Artery Disease

Contact Info

Product

Resources

About