Isringhaus H
Department of Thoracic and Cardiovascular Surgery, University of the Saarland, Homburg/Saar, FRG.
Thorac Cardiovasc Surg. 1987 Dec;35(6):348-51. doi: 10.1055/s-2007-1020261.
Until today, a routinely applicable method is not available for intraoperative imaging of the coronary vessels. Our experience with the first 23 patients is discussed to show whether high-frequency echocardiography (HFE) is able to close this gap and to image the coronary arteries intraoperatively in a manner which can be evaluated. After thoracotomy and connecting the heart-lung machine as well as insertion of a transatrial left ventricular vent, ultrasonography was carried out with a 12 MHz linear scanner with a water prerun in the LAD in all cases, and also in the RCA and circumflex branch in 12 cases using sterile ultrasound gel on the fibrillating heart. The results proved that the method is able to image the coronary arteries with good resolution in the transverse section and in the longitudinal course. HFE can be used in particular to locate the intramyocardial course of coronary vessels and in reoperations, for localization of stenoses and occlusions, for determination of optimal sites for anastomoses, for measuring of vessel diameter and degree of stenosis, and for imaging of anastomoses. It will be possible in the future to image and to check intraoperative dilatation and laser angioplasty with HFE.
直到今天，尚无一种可常规应用的方法用于冠状动脉的术中成像。本文讨论了我们对最初23例患者的经验，以表明高频超声心动图（HFE）是否能够填补这一空白，并以一种可评估的方式在术中对冠状动脉进行成像。开胸并连接心肺机以及插入经心房左心室引流管后，在所有病例中均使用12 MHz线性扫描仪在左前降支（LAD）进行水预运行的情况下进行超声检查，在12例病例中还在右冠状动脉（RCA）和回旋支使用无菌超声凝胶在颤动的心脏上进行检查。结果证明，该方法能够在横切面和纵行方向上以良好的分辨率对冠状动脉进行成像。HFE尤其可用于定位冠状动脉的心肌内走行以及在再次手术中，用于定位狭窄和闭塞、确定吻合的最佳部位、测量血管直径和狭窄程度以及对吻合口进行成像。未来有可能使用HFE对术中扩张和激光血管成形术进行成像和检查。
