Detection of Patency of Internal Mammary Artery Grafts to the Left Anterior Descending Artery by Transthoracic Doppler Echocardiography

Abstract

The existence of mosaic, retro, or sufficient ante flows strongly indicated the patency of LIMA to the LAD. When symptoms are possible to be derived from the occlusion of CABG to LAD, TTDE is a promising method to examine whether a LIMA to LAD bypass is patent.

Expected Diameter and Velocity Parameters for Internal Mammary Artery Mapping Procedures

“…Recently, some investigators have reported on the use of Doppler ultrasound for postoperative IMA graft surveillance. 7,8,15 These studies have shown consistent results comparing the preoperative and postoperative IMA flow patterns and velocities. 7,15 The postoperative changes demonstrate a change in the Doppler flow pattern from a high to low resistance signal with decrease in PSV and increase in EDV.…”

“…It has been proposed that these findings could be used to develop standardized methodology for long-term postoperative follow-up of IMA grafts with duplex ultrasound. 8…”

“…4 Most of the current data regarding IMA diameter and velocity criteria are driven from studies that included a small number of patients either for preoperative IMA assessment or postoperative graft surveillance. 4–9 Of note, these studies used different imaging modalities, including duplex ultrasound, echocardiography, intraoperative ultrasound, conventional angiography, and magnetic resonance imaging (MRI). 4–9…”

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

“…At present, postoperative angiography is still the golden standard to assess IMA graft patency but the invasive nature limits its routine use. Other methods were reported over the last years, including intravascular, transthoracic, and supraclavicular duplex ultrasonography, magnetic resonance imaging and multislice computed tomography 4–10 . Nowadays, 64‐multislice computed tomography (MSCT) angiography has potential diagnostic performance in the diagnosis of coronary artery disease and in (symptomatic) patients after bypass surgery.…”