TY - JOUR
T1 - Success of internal mammary bypass grafting can be assessed intraoperatively using myocardial contrast echocardiography
AU - Spotnitz, William D.
AU - Keller, Mark W.
AU - Watson, Denny D.
AU - Nolan, Stanton P.
AU - Kaul, Sanjiv
PY - 1988/7
Y1 - 1988/7
N2 - 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.
AB - 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.
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U2 - 10.1016/0735-1097(88)90374-9
DO - 10.1016/0735-1097(88)90374-9
M3 - Article
C2 - 2897985
AN - SCOPUS:0023913916
SN - 0735-1097
VL - 12
SP - 196
EP - 201
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 1
ER -