Comparison of coronary hemodynamics in patients with internal mammary artery and saphenous vein coronary artery bypass grafts: a noninvasive approach using combined two-dimensional and Doppler echocardiography

Department of Cardiology, Chiba Prefectural Tsurumai Hospital, Japan.

Blood flow in bypass grafts and recipient left anterior descending coronary arteries was evaluated with combined two-dimensional and Doppler echocardiography in 15 patients with an internal mammary artery graft and in 24 patients with a saphenous vein graft. Comparative studies of coronary hemodynamics were also performed regarding these two different grafting techniques. The graft vessel was detected in 11 (79%) of 14 patients with an internal mammary artery graft and in 20 (87%) of 23 with a saphenous vein graft. The recipient left anterior descending coronary artery was detected in 10 (67%) of the former group and 17 (71%) of the latter. The blood flow patterns obtained were generally biphasic, consisting of systolic and diastolic phases with higher velocity during diastole. The maximal diastolic flow velocity in internal mammary artery grafts was much higher than that in saphenous vein grafts. In patients with an internal mammary artery graft, the flow pattern characteristics within the recipient coronary artery were quite similar to those within the arterial graft, and flow velocities within the recipient coronary artery and the arterial graft were quantitatively almost identical. This outcome may contribute to the long-term patency seen in internal mammary artery grafts. On the other hand, the flow velocity in saphenous vein grafts was fairly low throughout the cardiac cycle. Flow velocity in the recipient coronary artery in patients with a saphenous vein graft was accelerated only in early diastole. As a result, the recipient coronary artery flow pattern and velocity differed substantially from those in the saphenous vein graft.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				C. M. Jones, A. Thanos, P. P. Tekkis, V. Malinovski, S. Purkayastha, A. Haq, J. Kokotsakis, and A. Darzi Does Doppler echography have a diagnostic role in patency assessment of internal thoracic artery grafts? Eur J Cardiothorac Surg, November 1, 2005; 28(5): 692 - 700. [Abstract] [Full Text] [PDF]

				M. Yoshitatsu, Y. Miyamoto, M. Mitsuno, K. Toda, M. Yoshikawa, S. Fukui, F. Nomura, N. Hirata, and K. Onishi Changes in left anterior descending coronary artery flow profiles after coronary artery bypass grafting examined by means of transthoracic Doppler echocardiography J. Thorac. Cardiovasc. Surg., November 1, 2003; 126(5): 1531 - 1536. [Abstract] [Full Text] [PDF]

				N. Hirata, N. Asaoka, A. Amemiya, S. Hatsuoka, T. Ueno, and Y. Kosakai Noninvasive evaluation of internal thoracic artery and left anterior descending coronary artery anastomotic sites using transthoracic Doppler echocardiography: comparison with coronary arteriography J. Thorac. Cardiovasc. Surg., October 1, 2003; 126(4): 1080 - 1086. [Abstract] [Full Text] [PDF]

				K.-J. Yoo, D. Choi, B. W. Choi, S.-H. Lim, and B.-C. Chang The comparison of the graft patency after coronary artery bypass grafting using coronary angiography and multi-slice computed tomography Eur J Cardiothorac Surg, July 1, 2003; 24(1): 86 - 91. [Abstract] [Full Text] [PDF]

				T. A Abdel Aziz, P. Kumar, N. Bazargani, E. Al-Hato, and N. Al Khaja Assessment of Coronary Bypass Graft Patency by Electron-Beam Computed Tomography Asian Cardiovasc Thorac Ann, June 1, 2003; 11(2): 102 - 106. [Abstract] [Full Text] [PDF]

				T.-P. Tsai, K.-C. Ueng, J.-M. Yu, Y.-C. Chang, and Y.-L. Wu Comparison of the Postoperative Blood Flow Waveforms of the Bypassing Grafts in Patients Following Minimally Invasive Direct Coronary Artery Bypass Chest, March 1, 2002; 121(3): 951 - 956. [Abstract] [Full Text] [PDF]

				F Chirillo, A Bruni, G Balestra, C Cavallini, Z Olivari, J D Thomas, and P Stritoni Assessment of internal mammary artery and saphenous vein graft patency and flow reserve using transthoracic Doppler echocardiography Heart, October 1, 2001; 86(4): 424 - 431. [Abstract] [Full Text] [PDF]

				N. Ishida, H. Sakuma, B. P. Cruz, T. Shimono, T. Tokui, I. Yada, K. Takeda, and C. B. Higgins MR Flow Measurement in the Internal Mammary Artery-to-Coronary Artery Bypass Graft: Comparison with Graft Stenosis at Radiographic Angiography Radiology, August 1, 2001; 220(2): 441 - 447. [Abstract] [Full Text] [PDF]

				S. E. Langerak, P. Kunz, H. W. Vliegen, H. J. Lamb, J. W. Jukema, E. E. van der Wall, and A. de Roos Improved MR Flow Mapping in Coronary Artery Bypass Grafts during Adenosine-induced Stress Radiology, February 1, 2001; 218(2): 540 - 547. [Abstract] [Full Text]

				J. C. Lin, D. L. Fisher, M. F. Szwerc, and J. A. Magovern Evaluation of graft patency during minimally invasive coronary artery bypass grafting with Doppler flow analysis Ann. Thorac. Surg., October 1, 2000; 70(4): 1350 - 1354. [Abstract] [Full Text] [PDF]

				T. Shimizu, T. Hirayama, H. Suesada, K. Ikeda, S. Ito, and S. Ishimaru Effect of flow competition on internal thoracic artery graft: Postoperative velocimetric and angiographic study J. Thorac. Cardiovasc. Surg., September 1, 2000; 120(3): 459 - 465. [Abstract] [Full Text] [PDF]

				R. De Paulis, F. Tomai, A. Gaspardone, L. Colagrande, P. Nardi, A. Ghini, F. Versaci, A. P. de Peppo, P. A. Gioffre, and L. Chiariello CORONARY FLOW RESERVE EARLY AND LATE AFTER MINIMALLY INVASIVE CORONARY ARTERY BYPASS GRAFTING IN PATIENTS WITH TOTALLY OCCLUDED LEFT ANTERIOR DESCENDING CORONARY ARTERY J. Thorac. Cardiovasc. Surg., October 1, 1999; 118(4): 604 - 609. [Abstract] [Full Text] [PDF]

				G. Tavilla, N. H.J. Pijls, E. Berreklouw, and K. H. Peels Noninvasive assessment of right gastroepiploic artery graft patency using transcutaneous color Doppler echocardiography Ann. Thorac. Surg., March 1, 1999; 67(3): 624 - 628. [Abstract] [Full Text] [PDF]

				K. Oda, K. Hirose, H. Nishimori, K. Sato, T. Yamashiro, and S. Ogoshi Assessment of internal thoracic artery graft with intraoperative color doppler ultrasonography Ann. Thorac. Surg., July 1, 1998; 66(1): 79 - 81. [Abstract] [Full Text] [PDF]

				O. Tasdemir, U. Kiziltepe, H. Y. Karagoz, B. Yamak, S. Korkmaz, and K. Bayazit LONG-TERM RESULTS OF RECONSTRUCTIONS OF THE LEFT ANTERIOR DESCENDING CORONARY ARTERY IN DIFFUSE ATHEROSCLEROTIC LESIONS J. Thorac. Cardiovasc. Surg., September 1, 1996; 112(3): 745 - 754. [Abstract] [Full Text]

				R. Cartier, O. S. Dias, M. Pellerin, Y. Hebert, and Y. Leclerc CHANGING FLOW PATTERN OF THE INTERNAL THORACIC ARTERY UNDERGOING CORONARY BYPASS GRAFTING: CONTINUOUS-WAVE DOPPLER ASSESSMENT J. Thorac. Cardiovasc. Surg., July 1, 1996; 112(1): 52 - 58. [Abstract] [Full Text]

				H. Takemura, M. Kawasuji, N. Sakakibara, T. Tedoriya, T. Ushijima, and Y. Watanabe Internal Thoracic Artery Graft Function During Exercise Assessed by Transthoracic Doppler Echography Ann. Thorac. Surg., March 1, 1996; 61(3): 914 - 919. [Abstract] [Full Text]

				M. A. Galjee, A. C. van Rossum, T. Doesburg, M. J. van Eenige, and C. A. Visser Value of Magnetic Resonance Imaging in Assessing Patency and Function of Coronary Artery Bypass Grafts : An Angiographically Controlled Study Circulation, February 15, 1996; 93(4): 660 - 666. [Abstract] [Full Text]

				J. J. Crowley and L. M. Shapiro Noninvasive Assessment of Left Internal Mammary Artery Graft Patency Using Transthoracic Echocardiography Circulation, November 1, 1995; 92(9): 25 - 30. [Abstract] [Full Text]

				M. Ciccone, D. di Noia, F. Corriero, A. Federici, and P. Rizzon Noninvasive Estimation of the Internal Mammary Artery Bypass Graft Patency: A Six-Year Follow-up Vascular and Endovascular Surgery, November 1, 1994; 28(9): 601 - 606. [Abstract] [PDF]

				J. A. M. van Son, S. H. Skotnicki, M. B. M. Peters, N. H. J. Pijls, L. Noyez, and W. N. J. C. van Asten Noninvasive hemodynamic assessment of the internal mammary artery in myocardial revascularization Ann. Thorac. Surg., February 1, 1993; 55(2): 404 - 409. [Abstract] [PDF]

				J. A. M. van Son, S. H. Skotnicki, H. A. Folmer, and W. N. J. C. van Asten Reactive hyperemia in the nonused internal mammary artery after median sternotomy Ann. Thorac. Surg., July 1, 1992; 54(1): 130 - 133. [Abstract] [PDF]