Can Late Supraclavicular Echo Doppler Reliably Predict Angiographical String Sign of Lima to Lad Area Grafts?

Hartman, Joost M.; Kelder, Hans; Ackerstaff, R.G.A.; van, Henry A. Swieten; Vermeulen, F.; Bogers, Ad J.J.C.

doi:10.1111/j.1540-8175.2007.00461.x

Cited by 2 publications

(3 citation statements)

References 31 publications

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“…Despite accurate and reliable assessment of native LITA before CABG, we cannot succeed to identify in situ LITA graft accurately after CABG at initial. This is partly because of unfavorable chest wall configuration, coexistent lung diseases and the learning curve experience (25 et al (26) stated that obtaining LITA graft non invasively with the transthoracic approach is difficult because of its narrow lumen and constant pulsatile movement. Therefore they evaluated the LITA graft flow with echo Doppler from the supraclavicular approach because the proximal part of the LITA graft is close to the chest wall and fixed with soft tissue and hence free from pulsatile displacement.…”

Section: Discussionmentioning

confidence: 99%

“…It shows high specificity, prevents invasive investigations and improves in patients with postoperative angina. Hartman et al (26) reported that peak diastolic and systolic velocities are the most discriminative factors for string sign LITA grafts and suggest postoperative supraclavicular duplex as a method to assess the patency of LITA to LAD area grafts allows discriminating functional grafts from string sign grafts. We want to mention one of our cases for supporting this suggestion.…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Yay

Boysan²,

Ünal³

et al. 2014

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

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“…A noninvasive method for risk stratification and clinical follow-up would be useful in those patients. The value of color Doppler ultrasonography (CDUS) with the supraclavicular approach for preoperative evaluation of the native LIMA as well as for the postoperative detection of LIMA graft patency was recently suggested [10, 11]. These studies focused mainly on the parameters of the ratio of peak flow velocities during the diastolic and systolic period or each parameter (the peak systolic velocity [PSV], peak diastolic velocity [PDV], and end-diastolic velocity [EDV]) on CDUS individually.…”

Section: Introductionmentioning

confidence: 99%

The Role of Color Doppler Ultrasonography in the Perioperative Period of Coronary Artery Bypass Grafting: Comparison with Transit-Time Flow Measurement

et al. 2021

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Introduction: The value of color Doppler ultrasonography (CDUS) with the supraclavicular approach for preoperative evaluation of the native left internal mammary artery (LIMA) as well as for the postoperative detection of LIMA graft patency was recently suggested. However, the parameters such as the flow volume and pulsatile index (PI) have not been studied in detail. Objectives: The objectives of this study were to analyze the LIMA data in the perioperative period and explore the relationships between the intraoperative graft flow with transit-time flow measurement (TTFM) and the postoperatively measured parameters with CDUS. Methods: Fifty-eight patients with significant stenosis (≥70%) or occlusions in left anterior descending artery (LAD) who were referred for isolated coronary artery bypass grafting (CABG) were enrolled in this study and examined by CDUS prior to CABG from April to July 2016. The perioperative measurements of proximal LIMA by CDUS were compared. In addition, the correlation between the intraoperative graft flow, such as the mean graft flow (MGF) and PI, and the immediate postoperative measurements of CDUS in LIMA bypassed grafts was statistically analyzed. Results: Six patients were excluded due to screening failure, or insufficient visualization of CDUS images for analysis. Fifty-two patients with in situ LIMA-LAD graft, with or without additional arterial grafts or saphenous vein grafts, were included in the final analysis. The postoperative diameters of proximal LIMA were not significantly different from preoperative diameters (2.21 ± 0.18 vs. 2.27 ± 0.22 mm, p = 0.070). The flow volume on the early postoperative CDUS significantly increased (39.77 ± 21.59 vs. 25.96 ± 13.17 mL/min, p < 0.001) and the PI significantly decreased (1.43 ± 0.46 vs. 4.20 ± 1.49, p < 0.001) versus those of preoperative measurements. The MGF had a moderate correlation with the flow volume on the early postoperative CDUS (r = 0.414, p = 0.002), and the PI by TTFM had a weak correlation with that by CDUS (r = 0.353, p = 0.010) as well. Conclusions: The MGF and PI by TTFM in CABG were associated with in situ LIMA graft parameters measured by CDUS studies. CDUS is a useful functional noninvasive tool for the preoperative screening and postoperative follow-up of patients with in situ LIMA bypass.

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Can Late Supraclavicular Echo Doppler Reliably Predict Angiographical String Sign of Lima to Lad Area Grafts?

Abstract: Postoperative supraclavicular duplex as a method to assess the patency of LIMA to LAD area grafts allows discriminating functional grafts from (distal) string sign grafts.

Cited by 2 publications

References 31 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

The Role of Color Doppler Ultrasonography in the Perioperative Period of Coronary Artery Bypass Grafting: Comparison with Transit-Time Flow Measurement

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