Kyo S, Matsumura M, Takamoto S, Yokote Y, Omoto R
First Department of Surgery, Saitama Medical School.
J Cardiol. 1989 Mar;19(1):1-8.
To evaluate noninvasively the patency of aortocoronary bypass grafts using the left internal mammary artery (LIMAG), color flow mapping Doppler echocardiography was performed in 23 consecutive patients. There were 22 males and one female. The average number of involved coronary arteries per patient was 2.5 +/- 0.6. The average number of bypassed graft anastomoses was 2.7 +/- 0.9, including 22 isolated LIMAG and one sequential LIMAG. The color flow mapping system used was a linear type 2-D Doppler system (Aloka SSD350) with a convex type transducer. Clear color flow visualization of LIMAG flow was obtained in nine of the 23 patients (39%) studied, with an average peak diastolic velocity of 22.5 +/- 8.7 cm/sec and an average systolic peak velocity of 12.6 +/- 5.7 cm/sec. The coronary angiograms of eight patients were obtained within two weeks after the echocardiographic examinations which demonstrated good graft patency in all LIMAG. Color flow visualization of LIMAG was obtained in four of the eight patients (50%). Although the detection rate was limited, LIMAG flow could be clearly visualized in nearly half the cases studied with stable reproducibility from the transcutaneous echo window. Thus, this technique can be a useful diagnostic means for long-term follow-up of LIMAG and for investigating coronary circulation in the future.
为了使用左乳内动脉(LIMAG)对主动脉冠状动脉搭桥移植血管的通畅性进行无创评估,对23例连续患者进行了彩色血流图多普勒超声心动图检查。其中男性22例,女性1例。每位患者受累冠状动脉的平均数量为2.5±0.6。搭桥移植血管吻合口的平均数量为2.7±0.9,包括22条孤立的LIMAG和1条序贯LIMAG。所使用的彩色血流图系统是带有凸阵探头的线性二维多普勒系统(Aloka SSD350)。在23例接受研究的患者中有9例(39%)获得了清晰的LIMAG血流彩色图像,平均舒张期峰值速度为22.5±8.7厘米/秒,平均收缩期峰值速度为12.6±5.7厘米/秒。在超声心动图检查后的两周内对8例患者进行了冠状动脉造影,结果显示所有LIMAG的移植血管通畅良好。在这8例患者中有4例(50%)获得了LIMAG的彩色血流图像。尽管检测率有限,但从经皮超声窗在近一半的研究病例中可以清晰地观察到LIMAG血流,且具有稳定的可重复性。因此,这项技术可成为未来对LIMAG进行长期随访以及研究冠状动脉循环的一种有用的诊断手段。