B Pavy1, A Tisseau. 1. Service de Réadaptation Cardiaque, Centre Hospitalier Loire-Vendée-Océan, BP 2, 44270, Machecoul, France. pavy.bruno@wanadoo.fr
Abstract
OBJECTIVE: The aim of the study is to demonstrate the feasibility, interest and limits of ultrasound exploration of left internal mammary artery grafts in cardiac rehabilitation. METHODS: From January 2000 to December 2008, 1434 patients entered in cardiac rehabilitation underlying coronary artery bypass graft, were studied by transthoracic doppler echocardiography in left internal mammary artery graft, from supraclavicular fossa. RESULTS: One thousand two hundred and fifty-nine grafts were recorded (87.8 %); the diameter was 2.6 +/- 0.3 mm, the peak systolic velocity 46.3 +/- 17.7 cm/s, the peak diastolic velocity 34.0 +/- 13.4 cm/s, the diastolic/systolic (D/S) peak velocity ratio 0.77 +/- 0.26 and the mean blood flow 64.3 +/- 34.5 ml/min. The D/S peak ratio is lower in the presence of high blood pressure or diabetes, is higher in men, with sequential graft or when left ventricle ejection fraction is low. It tends to increase by sportsmen. CONCLUSION: Transthoracic echo-doppler assessment of internal mammary artery grafts is easily useful and allows to establish a "functional identity card" of the graft in postoperative period, which will be used like a reference for the follow-up.
OBJECTIVE: The aim of the study is to demonstrate the feasibility, interest and limits of ultrasound exploration of left internal mammary artery grafts in cardiac rehabilitation. METHODS: From January 2000 to December 2008, 1434 patients entered in cardiac rehabilitation underlying coronary artery bypass graft, were studied by transthoracic doppler echocardiography in left internal mammary artery graft, from supraclavicular fossa. RESULTS: One thousand two hundred and fifty-nine grafts were recorded (87.8 %); the diameter was 2.6 +/- 0.3 mm, the peak systolic velocity 46.3 +/- 17.7 cm/s, the peak diastolic velocity 34.0 +/- 13.4 cm/s, the diastolic/systolic (D/S) peak velocity ratio 0.77 +/- 0.26 and the mean blood flow 64.3 +/- 34.5 ml/min. The D/S peak ratio is lower in the presence of high blood pressure or diabetes, is higher in men, with sequential graft or when left ventricle ejection fraction is low. It tends to increase by sportsmen. CONCLUSION: Transthoracic echo-doppler assessment of internal mammary artery grafts is easily useful and allows to establish a "functional identity card" of the graft in postoperative period, which will be used like a reference for the follow-up.