Apical transthoracic Doppler echocardiography can be useful for analysis of postoperative early function of the left internal thoracic artery

Current State of Intraoperative Echocardiography

“…Epicardial Doppler echocardiography with high frequency probes (typically 15 MHz) has been used effectively to evaluate flow in arterial grafts, which are prone to spasm. This allows avoiding undue manipulation of the grafts, which is often required when using transit time flow probes 50 . This technique has also been used to evaluate LV size and volume.…”

“…This allows avoiding undue manipulation of the grafts, which is often required when using transit time flow probes. 50 This technique has also been used to evaluate LV size and volume.…”

Assessment of Internal Thoracic Artery Patency With Transesophageal Echocardiography During Coronary Artery Bypass Graft Surgery

“…The peak and mean diastolic/systolic velocity ratios associated with problematic LITA grafts were significantly lower than those seen with healthy grafts (0.98 Ϯ 0.12 v 1.67 Ϯ 0.24 and 0.87 Ϯ 0.10 v 1.65 Ϯ 0.21, respectively). 6 The authors observed no stenosis in LITA grafts when at least 1 of the parameters of peak and mean velocity ratios and velocity time integral ratio was greater than its corresponding critical value. Therefore, the authors conclude that all 3 parameters should be measured and assessed and that LITA graft patency cannot be properly evaluated with only one of these parameters.…”

“…If both ratios are not at least 0.6, the anastomosis or conduit may become occluded. 5 Hata et al 6 reported that the LITA graft was detected in all of 66 patients (100%) with Doppler echocardiography from the apical approach. The peak and mean diastolic/systolic velocity ratios associated with problematic LITA grafts were significantly lower than those seen with healthy grafts (0.98 Ϯ 0.12 v 1.67 Ϯ 0.24 and 0.87 Ϯ 0.10 v 1.65 Ϯ 0.21, respectively).…”

“…Therefore, the ability to intraoperatively assess the patency of an internal thoracic artery graft is important. Recent studies have shown that transthoracic Doppler echocardiography using supraclavicular, 3 intercostal, 4,5 or apical 6 approaches can reliably assess the patency of the internal thoracic artery. However, these methods are only useful for postoperative assessment.…”