S Toyota1, Y Amaki. 1. Department of Anesthesiology, Jikei University School of Medicine, Tokyo, Japan.
Abstract
STUDY OBJECTIVE: To measure coronary sinus blood flow during coronary artery bypass graft (CABG) with transesophageal echocardiography (TEE). DESIGN: Prospective study. SETTING: Elective cardiac surgery at a university hospital. PATIENTS: Thirty-one ASA physical status III and IV adult patients free of significant coexisting disease and undergoing CABG. INTERVENTION: We measured coronary sinus blood flow velocity by using TEE and hemodynamic variables, before and after cardiopulmonary bypass (CPB) and after CPB. MEASUREMENTS AND MAIN RESULTS: We obtained a complete set of control measurements for 29 subjects (94%) and a complete set of post-CPB measurements in 28 patients (90%). In the normal group, peak velocity, and velocity time integral (VTI) of coronary sinus blood flow in the post-CPB period increased significantly compared with the pre-CPB period with CABG (n = 23). In the group of new regional wall motion abnormalities in the post-CPB period, peak velocity and VTI of coronary sinus blood flow in the post-CPB period did not increase significantly compared with the pre-CPB period by CABG (n = 5). CONCLUSIONS: We were able to measure the coronary sinus flow velocity by pulse-Doppler TEE during CABG. The peak velocity and VTI of coronary sinus blood flow in the post-CPB period increased significantly compared with in the pre-CPB period by CABG. The results of this preliminary study show the feasibility of clinical evaluation of CABG intraoperatively.
STUDY OBJECTIVE: To measure coronary sinus blood flow during coronary artery bypass graft (CABG) with transesophageal echocardiography (TEE). DESIGN: Prospective study. SETTING: Elective cardiac surgery at a university hospital. PATIENTS: Thirty-one ASA physical status III and IV adult patients free of significant coexisting disease and undergoing CABG. INTERVENTION: We measured coronary sinus blood flow velocity by using TEE and hemodynamic variables, before and after cardiopulmonary bypass (CPB) and after CPB. MEASUREMENTS AND MAIN RESULTS: We obtained a complete set of control measurements for 29 subjects (94%) and a complete set of post-CPB measurements in 28 patients (90%). In the normal group, peak velocity, and velocity time integral (VTI) of coronary sinus blood flow in the post-CPB period increased significantly compared with the pre-CPB period with CABG (n = 23). In the group of new regional wall motion abnormalities in the post-CPB period, peak velocity and VTI of coronary sinus blood flow in the post-CPB period did not increase significantly compared with the pre-CPB period by CABG (n = 5). CONCLUSIONS: We were able to measure the coronary sinus flow velocity by pulse-Doppler TEE during CABG. The peak velocity and VTI of coronary sinus blood flow in the post-CPB period increased significantly compared with in the pre-CPB period by CABG. The results of this preliminary study show the feasibility of clinical evaluation of CABG intraoperatively.