Suwa M, Suma H, Hirota Y, Kawamura K, Sasaki S, Takeuchi A, Tsuji T
J Cardiogr. 1985 Dec;15(4):957-67.
We attempted intraoperative ultrasonic visualization of the coronary arteries of animal models and of patients who underwent coronary artery bypass surgery. Ultrasonic visualization of coronary vessels using a high frequency wide band micro-transducer (3.5-9.0 MHz) was first attempted in three open-chest dogs. The coronary arteries were well visualized from the epicardium with and without contrast perfusion, and the experimentally-occluded portion was well imaged. Subsequently, this technique was clinically applied in two patients undergoing cardiac surgery for valvular and congenital heart diseases, and in nine patients undergoing coronary artery bypass surgery. Gas-sterilized probes were placed directly over the cardiac surface. Ultrasonic imaging of the coronary artery was performed to detect the coronary arteries beneath the fat tissue; image the lesions in coronary vessels, especially those not visualized by angiography; determine the site of bypass grafting and evaluate the graft-ability to the distal branch (the latter was poorly visualized via collateral circulation or not visualized angiographically because of total occlusion at a proximal site); and observe the effects of bypass grafting and intraoperative angioplasty of coronary arteries after these procedures. This ultrasonic technique was found to be useful for the intraoperative evaluation of coronary vessels for coronary artery bypass surgery.
我们尝试对动物模型以及接受冠状动脉搭桥手术的患者的冠状动脉进行术中超声可视化检查。首先在三只开胸犬身上尝试使用高频宽带微换能器（3.5 - 9.0兆赫）对冠状血管进行超声可视化。在有或无造影剂灌注的情况下，冠状动脉在心外膜处均能清晰显示，且实验性闭塞部分成像良好。随后，该技术被临床应用于两名因瓣膜性和先天性心脏病接受心脏手术的患者以及九名接受冠状动脉搭桥手术的患者。将经过气体灭菌的探头直接放置在心脏表面。进行冠状动脉的超声成像以检测脂肪组织下方的冠状动脉；对冠状血管中的病变进行成像，尤其是那些血管造影无法显示的病变；确定搭桥移植的部位并评估移植到远端分支的可行性（由于近端部位完全闭塞，通过侧支循环后者显示不佳或血管造影无法显示）；并观察这些操作后冠状动脉搭桥移植和术中血管成形术的效果。发现这种超声技术对冠状动脉搭桥手术中冠状血管的术中评估有用。
