Pedicled arterial grafts in coronary surgery : postoperative echo color-Doppler study

In 1994 a mid-term postoperative echo color-Doppler ultrasound was performed to check the pedicled arterial conduits used in coronary surgery, such as the left and right internal mammary arteries (LIMA, RIMA) and the right gastroepiploic artery (RGEA). This evaluation was made in 31 patients with a previous nonemergent complete arterial myocardial revascularization. The pedicled arterial grafts studied were 71 (31 LIMA, 15 RIMA and 25 RGEA). The Doppler spectrum (combined systolic/diastolic waveform), the diameter and the flow of every arterial graft was always identified (100% of detection) and there was a statistical significative difference between mean RGEA flow versus mean LIMA and RIMA flow (p<0.05). All the conduits studied were characterized by a good diastolic and end-diastolic velocity, evidence of normal graft patency. The postoperative angiogram of the LIMA, RIMA and RGEA conduits was performed in 27/31 (87.1%) patients and it showed 100% patency of arterial grafts used and of anastomoses. The echo color-Doppler data were compared to postoperative angiographic results. The echo color-Doppler imaging of the pedicled arterial grafts used in coronary surgery seems to be a promising technique for the postoperative serial assessment of the LIMA, RIMA and RGEA conduit function, because it is noninvasive, safe, easy, quick to perform and the preliminary results of echo color-Doppler ultrasound versus angiography are satisfactory.