Detection of Internal Thoracic Artery Dissection at Coronary Anastomosis Using Intraoperative 15-MHz High-Frequency Epicardial Ultrasound | Zendy

Taiju Watanabe | Zendy; Hirokuni Arai | Zendy; Keiji Oi | Zendy; Tsuyoshi Hachimaru | Zendy; Hidehito Kuroki | Zendy; Tatsuki Fujiwara | Zendy; Tomohiro Mizuno | Zendy

Open Access

Detection of Internal Thoracic Artery Dissection at Coronary Anastomosis Using Intraoperative 15-MHz High-Frequency Epicardial Ultrasound

Author(s) -

Taiju Watanabe,

Hirokuni Arai,

Keiji Oi,

Tsuyoshi Hachimaru,

Hidehito Kuroki,

Tatsuki Fujiwara,

Tomohiro Mizuno

Publication year - 2014

Publication title -

circulation

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 7.795

H-Index - 607

eISSN - 1524-4539

pISSN - 0009-7322

DOI - 10.1161/circulationaha.114.008705

Subject(s) - medicine , dissection (medical) , anastomosis , medical school , cardiothoracic surgery , aortic dissection , general surgery , surgery , aorta , medical education

A 66-year-old man with a history of diabetes mellitus presented with angina pectoris with 3-vessel disease, and he underwent off-pump coronary artery bypass grafting via median sternotomy. After performing bypass grafting of the left internal thoracic artery to the left anterior descending artery, the appearance of anastomosis configuration appeared to be acceptable. However, transit time flow measurement (TTFM) showed that the mean graft flow was 10 mL/min, which was less than expected despite an acceptable flow curve with a diastolic flow pattern, a pulsatility index (index of resistance) of 2.0, and diastolic filling (proportion of diastole with coronary flow) of 65% (Figure 1). In addition to TTFM, the …

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