Success of internal mammary bypass grafting can be assessed intraoperatively using myocardial contrast echocardiography

William D. Spotnitz, Mark W. Keller, Denny D. Watson, Stanton P. Nolan, Sanjiv Kaul

    Research output: Contribution to journalArticlepeer-review

    21 Scopus citations

    Abstract

    To determine whether the success of internal mammary artery bypass grafting can be assessed intraoperatively using myocardial contrast echocardiography, sonicated Renografin-76 was injected into the aortic root of 11 dogs during the delivery of cardioplegic solution. Studies were performed with the left anterior descending coronary artery patent and totally occluded, and after internal mammary artery bypass grafting distal to the occluded vessel. Flow rate during cardioplegia was constant for all three stages in each experiment. Myocardial contrast echocardiography clearly demonstrated homogeneous myocardial perfusion with the left anterior descending coronary artery patent, lack of perfusion in the left anterior descending artery bed during its occlusion and excellent perfusion of the occluded bed after internal mammary artery bypass grafting distal to the occlusion in 10 of the 11 dogs. In one dog, the bypass graft was technically inadequate and contrast opacification was not noted in the left anterior descending artery bed after internal mammary artery bypass grafting. The exponential function C(t) = Ae-αt + Be-βt was fitted to computer-derived time-intensity curves from the myocardium, where α denotes contrast washout and β denotes contrast appearance. Respective values for α and β (mean + 1 SD) were similar for the patent left anterior descending coronary artery and after internal mammary artery bypass grafting distal to the occluded artery (0.11 ± 0.10 versus 0.10 ± 0.10, and 2.5 ± 2.4 versus 1.1 ± 0.56). In conclusion, myocardial contrast echocardiography has potential for intraoperative assessment of the adequacy of coronary artery bypass grafting.

    Original languageEnglish (US)
    Pages (from-to)196-201
    Number of pages6
    JournalJournal of the American College of Cardiology
    Volume12
    Issue number1
    DOIs
    StatePublished - Jul 1988

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

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