Assessment of left mammary artery grafts (LIMA) to left anterior descending artery (LAD) after off-pump coronary artery bypass grafting by color Doppler

Driever, R.; Fuchs, Stefan; Schmitz, Edgar; Vetter, H

doi:10.1016/s0967-2109(01)00094-1

Cited by 8 publications

(12 citation statements)

References 8 publications

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“…Obstruction can occur between the origin of the LITA and the distal coronary bed. Proximally occluded grafts have an absence of flow and distally occluded grafts have a systolic dominant pattern (10)(11)(12)(13)(14)(15)(16)(17)(18). A poor LAD target vessel quality, competitive flow from a partially occluded proximal LAD, residual LITA side branches and the contractility and viability of the perfused myocardium can affect the Doppler flow values also.…”

Section: Study Population and Protocolmentioning

confidence: 99%

Diagnostic accuracy of Doppler ultrasonography for assessment of internal thoracic artery graft patency

Yay

Boysan²,

Ünal³

et al. 2014

Anadolu Kardiyol Derg

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Objective: The main purpose of this study was to assess the patency of left internal thoracic artery (LITA) graft by using color Doppler ultrasonography (CDUSG) and furthermore to determine the sensitivity and specificity of CDUSG for patency by using coronary angiography as the reference standard. Methods: This study is an observational cohort study on diagnostic accuracy that was held between August 2008 and October 2009. CDUSG was performed in 138 consecutive patients who had angina symptom or positive ischemic findings following coronary artery bypass surgery. LITA blood flow velocity at peak-systole (PSV), diastole (PDV) and end-diastole (EDV) was recorded. All patients were also assessed by coronary angiography for LITA graft patency. Statistical analysis was performed by using independent samples t-test, Mann-Whitney-U test, chisquare test and receiver operating curve analyses (ROC). Results: Seventy-eight of all patients had functional LITA grafts and 59 patients had dysfunctional LITA grafts according to CDUSG-derived parameters, whereas we cannot conclude about one patient's LITA graft functionality. The LITA grafts were visualized angiographically in all cases. Of all 138 patients, 60 patients had dysfunctional LITA grafts after angiographic evaluation. The ROC analyses showed that PDV (AUC=0.899, 95% CI 0.844 to 0.953; p<0.001) and EDV (AUC=0.900; 95% CI 0.847 to 0.953; p<0.001) values were also strongly associated with graft functionality. We found out that CDUSG predicts LITA graft functionality with a sensitivity and specificity of 100% and 98.4% respectively. The accuracy of the CDUSG was calculated as 99.3%. Conclusion: CDUSG is a reliable non-invasive method for assessment of LITA graft patency. (Anadolu Kardiyol Derg 2014; 14: 286-91)

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Section: Study Population and Protocolmentioning

confidence: 99%

Diagnostic accuracy of Doppler ultrasonography for assessment of internal thoracic artery graft patency

Yay

Boysan²,

Ünal³

et al. 2014

Anadolu Kardiyol Derg

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“…In these cases, Sewell´s pedicle a structure composed of the LITA, veins and a 1.5-cm layer of endothoracic fascia, pleura and muscle would be used [26,31,32]. The Doppler echocardiograph study of the LITA has been considered, over these years, as an important noninvasive method for the evaluation of the permeability and flow of the graft [15][16][17][18][19]. Among the flow parameters investigated by means of echocardiography, the STO/ RTO ratio of the grafted LITA is considered by numerous authors as the best form of evaluating the capacity of the graft to offer an adequate blood flow in situations of increased demand, that is, in situations of metabolic stress [33][34][35].…”

Section: Commentsmentioning

confidence: 99%

“…In [15][16][17][18][19][20][21][22] Schumacher [36] published a study demonstrating the induction of angiogenesis in a ischemic human myocardium, a conduct that is increasingly being considered for patients who are not candidates for direct or percutaneous revascularization.…”

Section: Commentsmentioning

confidence: 99%

“…Aiming to develop a less invasive technique with a lower morbid-mortality rate, Lobo Filho proposed a variation of the original technique described by Vineberg [15][16][17][18][19][20][21][22] using a pacemaker lead introducing kit [14].…”

Section: Introductionmentioning

confidence: 99%

“…The Doppler echocardiograph study of the LITA linked by a pedicle to the anterior interventricular artery (AIV) has become more important over the last years as a non-invasive method to evaluate the flow and the permeability of the graft [15][16][17][18][19]. In works published between 1992 and 2001, De Simone et al [15], Chirillo et al [20], De Bono et al [21] and Van Son et al [22] demonstrated successful detection of the LITA in 100% of the cases.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Vineberg Procedure by "Vineberg technique modified by Lobo Filho": morbidity and mortality in the imediate post operative period, angiography results and flow analyze of the left internal thoracic artery implanted

Filho¹,

Leitão²,

Filho³

et al. 2003

Rev Bras Cir Cardiovasc

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Does Doppler echography have a diagnostic role in patency assessment of internal thoracic artery grafts?

Jones

Athanasiou

Tekkis

et al. 2005

European Journal of Cardio-Thoracic Surgery

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The amount of literature published over the past decade comparing coronary angiography with transthoracic Doppler echocardiography assessment of internal thoracic artery graft patency after CABG is substantial. There has been no review of the available literature, and conflicting reports of diagnostic accuracy have prevented routine use of transthoracic Doppler in graft patency assessment. Thus, this article reviews the available literature on diagnostic accuracy of transthoracic Doppler echocardiography of coronary bypass grafts. Relevant studies were identified and meta-analysis of diagnostic accuracy was performed. Study quality was assessed. Quantitative data synthesis included calculation of sensitivity, specificity, summary receiver operating characteristic curve analysis, pooled analysis and meta-regression of accuracy against study quality, publication date, angina, probe frequency and diagnostic criteria. Twenty studies of 929 patients produced 26 results included for analysis. Grafts were not visualized in 93 (10%) patients. Pooled sensitivity (85%) and specificity (94%) and diagnostic odds ratio (100.7) were high. SROC analysis showed an area under the curve of 0.96. Heterogeneity of results was due to variations in diagnostic criteria and study size. Subgroup analysis showed best performance in patients with postoperative angina (p = 0.014). Study quality did not affect results. Diastolic fraction less than 0.5 (sensitivity 89%, specificity 94%) was shown to be the best criterion for prediction of stenosis. Performance was lower using peak diastolic to systolic velocity ratio less than 1 (sensitivity 85%, specificity 86%). Transthoracic Doppler echography is effective in first-line assessment of left internal thoracic artery graft patency. It shows high specificity, prevents invasive investigations and improves in patients with postoperative angina. TDE is best used in combination with other non-invasive tests due to its inability to visualize the graft. The potential for use in postoperative coronary bypass patients is high.

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Assessment of left mammary artery grafts (LIMA) to left anterior descending artery (LAD) after off-pump coronary artery bypass grafting by color Doppler

Cited by 8 publications

References 8 publications

Diagnostic accuracy of Doppler ultrasonography for assessment of internal thoracic artery graft patency

Diagnostic accuracy of Doppler ultrasonography for assessment of internal thoracic artery graft patency

Vineberg Procedure by "Vineberg technique modified by Lobo Filho": morbidity and mortality in the imediate post operative period, angiography results and flow analyze of the left internal thoracic artery implanted

Does Doppler echography have a diagnostic role in patency assessment of internal thoracic artery grafts?

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