Measurement of coronary sinus flow using transesophageal echocardiography in patients undergoing coronary artery bypass grafting.

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.