Stress Doppler echocardiography of the internal thoracic artery - A new non-invasive approach for functional assessment after minimally invasive coronary bypass grafting

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Abstract

Minimally invasive surgery for coronary revascularization using the left internal thoracic artery (ITA) has gained increasing interest. For control of graft function the established transcutaneous color-Doppler echocardiography in combination with a stress-test was performed to test the ability of this novel technique. Twenty-one patients having received a single ITA-graft were evaluated early postoperatively at rest and during isometric stress test with a handgrip exercise. Compared to the right internal thoracic artery, the mainly systolic flow is changed to a wide diastolic component when the left ITA is anastomosed to the coronary artery. The peak systolicypeak diastolic velocity ratio changed from 4.5 ± 1.9 to 1.4 ± 0.47 (P < 0.0001). During stress reaction with the isometric handgrip maneuver the grafted ITA showed a significant increase of the mean diastolic flow (29.1 < 13.3 to 44.3 ± 14.7 cm/s, P < 0.0001) and total blood flow (124.8 ± 55.4 ml/min to 176.6 ± 71.7 ml/min), which may demonstrate an efficient bypass function. We conclude, that the noninvasive measurement of ITA-graft function with Doppler-ultrasound may be a clinically useful method to assess the functional status after minimally invasive coronary artery bypass grafting. In combination with the hand-grip test it represents a valid new technique with the potential to estimate graft patency. © 2006 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

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Marx, R., Kalweitb, G., Sunderdiekc, U., Jaxd, T. W., Kleine, R. M., Szaboa, S., … Gülkere, H. (2006). Stress Doppler echocardiography of the internal thoracic artery - A new non-invasive approach for functional assessment after minimally invasive coronary bypass grafting. Interactive Cardiovascular and Thoracic Surgery, 5(5), 584–588. https://doi.org/10.1510/icvts.2006.129007

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