Abstract
The evaluation of native coronary arteries in cardiac surgery represents a useful tool to detect coronary artery stenosis, identify the target artery, and choose the best anastomotic site. Intraoperative graft assessment is a fundamental step of coronary artery bypass grafting. It is able to reduce graft failure related to technical error, improving both short- and long-term outcome of patients submitted to surgical myocardial revascularization. Herein procedures of graft assessment are described, reporting their strengths and limitations.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Sahn DJ, Barratt-Boyes BG, Graham K, et al. Ultrasonic imaging of the coronary arteries in open-chest humans: evaluation of coronary atherosclerotic lesions during cardiac surgery. Circulation. 1982;66:1034–44.
McPherson DD, Armstrong M, Rose E, et al. High frequency epicardial echocardiography for coronary artery evaluation: in vitro and in vivo validation of arterial lumen and wall thickness measurements. J Am Coll Cardiol. 1986;8:600–6.
Di Giammarco G, Marinelli D, Foschi M, Di Natale M, Tancredi F, Di Mauro M. Intraoperative imaging to detect coronary stenosis in no-angiography patients. Asian Cardiovasc Thorac Ann. 2017;25:446–9.
Grondin CM, Castonguay YR, Lepage G, Meere C, Grondin P. Aortocoronary bypass grafts: early postoperative angiographic evaluation and reexploration for stenosis or thrombosis of the vein graft. Arch Surg. 1971;103:535–8.
Laustsen J, Pedersen EM, Terp K, et al. Validation of a new transit time ultrasound flowmeter in man. Eur J Vasc Endovasc Surg. 1996;12:91–6.
D’Ancona G, Karamanoukian HL, Salerno TA, Schmid S, Bergsland J. Flow measurement in coronary surgery. Heart Surg Forum. 1999;2:121–4.
Di Giammarco G, Pano M, Cirmeni S, Pelini P, Vitolla G, Di Mauro M. Predictive value of intraoperative transit-time flow measurement for short-term graft patency in coronary surgery. J Thorac Cardiovasc Surg. 2006;132:468–74.
Kim KB, Kang CH, Lim C. Prediction of graft flow impairment by intraoperative transit time flow measurement in off-pump coronary artery bypass using arterial grafts. Ann Thorac Surg. 2005;80:594–8.
Tokuda Y, Song M, Ueda Y, Usui A, Akita T. Predicting early coronary artery bypass graft failure by intraoperative transit time flow measurement. Ann Thorac Surg. 2007;84:1928–33.
Kieser TM, Rose S, Kowalewski R, Belenkie I. Transit-time flow predicts outcomes in coronary artery bypass graft patients: a series of 1000 consecutive arterial grafts. Eur J Cardiothorac Surg. 2010;38:155–62.
Di Giammarco G, Canosa C, Foschi M, et al. Intraoperative graft verification in coronary surgery: increased diagnostic accuracy adding high-resolution epicardial ultrasonography to transit-time flow measurement. Eur J Cardiothorac Surg. 2014;45:e41–5.
Gaudino M, Di Mauro M, Iacò AL, Canosa C, Vitolla G, Calafiore AM. Immediate flow reserve of Y thoracic artery grafts: an intraoperative flowmetric study. J Thorac Cardiovasc Surg. 2003;126:1076–9.
Di Giammarco G, Marinelli D, Foschi M, Di Mauro M. Intraoperative graft verification in coronary surgery. J Cardiovasc Med (Hagerstown). 2017;18:295–304.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Informed consent and ethical committee approval
Not applicable as the manuscript is a review paper.
Electronic supplementary material
Video 1
Technique of intraoperative visualization of coronary arteries by high resolution imaging (MOV 107514 kb)
Rights and permissions
About this article
Cite this article
Di Giammarco, G., Marinelli, D. Intraoperative graft assessment and imaging of native coronary arteries. Indian J Thorac Cardiovasc Surg 34 (Suppl 3), 297–301 (2018). https://doi.org/10.1007/s12055-018-0697-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12055-018-0697-0