Intraoperative detection of embedded coronary arteries in MIDCAB using a color Doppler microprobe

Oda, Katsushi; Hirose, Katsumi; Fukutomi, Takashi; Yamashiro, Toshiyuki; Ogoshi, Shohei

doi:10.1016/s0003-4975(99)00336-7

Cited by 20 publications

(14 citation statements)

References 6 publications

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“…Transducer size gradually decreased from rod-shaped transducers as large as 24 9 2.5 cm that were used in the pioneering 1980s studies [2][3][4] to (mini-) transducers as small as 1.5 9 0.9 9 0.6 cm [10,12,13,[15][16][17][20][21][22][23][24][25][26][27][28][29][30] (Fig. 1A).…”

Section: Transducer Sizementioning

confidence: 99%

“…Ninety-six cases of successful coronary artery localization with ECUS when conventional localization failed have been described [3,9,15,24,29,32]. Localization by ECUS took only a few minutes and allowed targeted dissection of the epicardial fat, minimizing risk and time consumption [3,17].…”

Section: Localization and Identification By Ecusmentioning

confidence: 99%

“…Localization by ECUS took only a few minutes and allowed targeted dissection of the epicardial fat, minimizing risk and time consumption [3,17]. For LAD identification, the underlying ventricular septum and the presence of septal perforators serve as distinctive echocardiographic landmarks [15,29]. Arteries can be discriminated from accompanying veins by the presence of calcifications and plaque and in color Doppler imaging, by the different color filling due to opposite flow directions [3,22,25].…”

Section: Localization and Identification By Ecusmentioning

confidence: 99%

“…a Presented as number of site changes per total number of sites assessed for this purpose; b Mentioned that deeply located arteries could be found (no numbers given); c Number of successfully imaged arteries; an additional 19 could not be visualized due to the rigid probe handle. All patients were operated through a sternotomy approach, except the five patients from [15] Site selection with ECUS With ECUS, the quality of the target coronary artery can be rapidly and accurately assessed [1,3,5,9,11,12,15,17,20,22,24,29,30,32]. Measurement of the coronary lumen (as well as the internal mammary artery for size matching) by ECUS correlates well with both histological and angiographic dimensions [1,5,11,17,19,20].…”

Section: Conventional Site Selectionmentioning

confidence: 99%

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High-frequency epicardial ultrasound: review of a multipurpose intraoperative tool for coronary surgery

et al. 2008

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Background In open-chest coronary artery bypass grafting (CABG), the surgeon faces several intraoperative challenges: (1) to locate the target coronary artery, (2) to select the optimal anastomotic site, and (3) to assess the quality of the graft and distal anastomosis. Endoscopically, these three diagnostic aims are particularly challenging. Methods We reviewed the literature on the intraoperative application of high-frequency (6.5-15 MHz) epicardial ultrasound (ECUS) in CABG to aid in these challenges. Results Overall, ECUS was used in 628 patients to visualize and assess 912 (segments of) coronary arteries, as well as 418 grafts and distal anastomoses. In 96 cases, ECUS successfully located a coronary artery that was buried in the epicardial and/or myocardial tissue. In 37/155 (24%) imaged anastomotic sites, an alternative site free of pathology was selected. For quality assessment of the coronary anastomosis, experimental validation of ECUS included 218 anastomoses in ex vivo and animal models. ECUS showed high sensitivity (0.98) and specificity (1.00) for detection of anastomotic construction errors in 120 ex vivo anastomoses. In 418 grafts and distal anastomoses evaluated in patients, irregularities leading to revision were detected in 8 (1.9%) anastomoses and minor irregularities in an additional 23 (5.5%) anastomoses. However, little is known about the effect on long-term patency of specific anastomotic abnormalities revealed by ECUS. Scanning of arteries and anastomoses required several minutes. Current size ultrasound probes allowed successful experimental robot-assisted endoscopic application of ECUS. Conclusions CABG may be facilitated and improved in several ways by intraoperative high-frequency epicardial ultrasound scanning. Totally endoscopic CABG may benefit from ultrasound diagnostics in particular.

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Section: Transducer Sizementioning

confidence: 99%

Section: Localization and Identification By Ecusmentioning

confidence: 99%

Section: Localization and Identification By Ecusmentioning

confidence: 99%

Section: Conventional Site Selectionmentioning

confidence: 99%

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High-frequency epicardial ultrasound: review of a multipurpose intraoperative tool for coronary surgery

et al. 2008

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“…The left anterior descending (LAD), considered the gold standard of coronary bypass surgery, takes a deep intramyocardial course [3]. It is difficult to locate the LAD in the case of an intramyocardial LAD because of a thick epicardial adipose tissue or epicardial scar tissue.…”

Section: A Coronary Artery Bypass Graft Surgerymentioning

confidence: 99%