Epicardial Ultrasonography: A Potential Method for Intraoperative Quality Assessment of Coronary Bypass Anastomoses? Per Kristian Hol, MD, Kai Andersen,

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Presentation transcript:

Epicardial Ultrasonography: A Potential Method for Intraoperative Quality Assessment of Coronary Bypass Anastomoses? Per Kristian Hol, MD, Kai Andersen, MD, PhD, Helge Skulstad, MD, PhD, Per Steinar Halvorsen, MD, Per Snorre Lingaas, MD, Rune Andersen, MD, Jacob Bergsland, MD, Erik Fosse, MD, PhD The Annals of Thoracic Surgery Volume 84, Issue 3, Pages 801-807 (September 2007) DOI: 10.1016/j.athoracsur.2007.04.025 Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Intraoperative epicardial ultrasonography demonstrating a patent internal mammary artery to left anterior descending artery anastomosis, with diameter measurements performed at five different sites. (DA = length of the anastomosis proper; DM = diameter of the distal mammary artery; D0 = diameter of the heel of the anastomosis; D1 = diameter of the toe of the anastomosis; D2 = diameter of left anterior descending coronary artery.) The Annals of Thoracic Surgery 2007 84, 801-807DOI: (10.1016/j.athoracsur.2007.04.025) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 The diameters measured by epicardial ultrasonography were poorly correlated with the measurements by intraoperative angiography, exemplified by the diameter of the distal mammary artery. The differences of the diameter measurements plotted against the mean diameters (circles), with mean difference and 95% limits of agreement are indicated (Bland-Altman analyses). The mean difference is 0.06 mm, but the limits of agreements are −0.95 and +1.06 mm. The Annals of Thoracic Surgery 2007 84, 801-807DOI: (10.1016/j.athoracsur.2007.04.025) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Dissection in left anterior descending artery around the distal anastomosis, demonstrated by (A) intraoperative angiography, but not detected by (B) epicardial ultrasonography. The Annals of Thoracic Surgery 2007 84, 801-807DOI: (10.1016/j.athoracsur.2007.04.025) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions