Arteria thoracica interna-Bypass - Grundlagen der Dopplersonographie für die prä- und postoperative Diagnostik

Abstract

During the last 25 years the internal thoracic artery has become a well established conduit for coronary revascularization. Next to angiography, duplex-sonography is increasingly used as a non-invasive imaging procedure for the evaluation of this graft vessel. Preoperative investigation in 117 patients has yielded a high level of agreement between angiography and duplex-sonography. While the preoperative flow-pattern is dominated by systolic flow as it is typical for vessels supplying skeletal muscle, the postoperative findings show an adaptation to the coronary vascular bed as the diastolic flow increases. These non-invasive measurements are well matched with invasive intravascular recordings. Coronary angiography and duplex-sonography of the internal thoracic artery yielded comparable findings in respect to the procedural result. Considering the increasing use of the internal thoracic artery in coronary artery bypass surgery, this non-invasive method should gain increasing relevance.

Disturbed Endothelial Function of the Internal Thoracic Artery in Patients with Coronary Artery Disease

“…Since all medications were withdrawn for at least 24 h only the lipid-lowering therapy in the group of patients with coronary artery disease may cause vasoactive effects and improve vasomotion [20]. Systolic peak flow velocities of the ITA measured from the third intercostal space are in accordance with our own data [21,22] and the results of other investigators [23,17]. At basal conditions and during handgrip-maneuver mean and peak diastolic flow velocities were significantly decreased in patients with coronary artery disease.…”

Angioplasty of the internal thoracic artery bypass-graft an alternative to reoperation

“…This method is considered to be a useful non-invasive diagnostic tool for investigation of the internal thoracic artery-graft function following operation [49][50][51][52]. With the use of exercise [49] you get an additional information about the assessment of the graft function [53].…”

RIVA-PTCA via Arteria-thoracica-interna-Bypass mit dopplersonographischer Erfolgskontrolle – Eine Kasuistik mit Literaturübersicht

“…Neben der angiographischen Darstellung des Bypassgefäßes hat sich die transkutane Ultraschall-Duplex-Sonographie als ein nichtinvasives Untersuchungsverfahren etabliert, die Funktion des Arteria-thoracica-interna-Bypasses im postoperativen Verlauf zu untersuchen (6, 31,36). Es liegt jedoch nach unserem Kenntnisstand bis jetzt keine Beschrei-bung einer nichtinvasiven Untersuchung zur Beurteilung des Interventionsergebnisses in diesem Bypassgefäß vor.…”