Sahn D J, Barratt-Boyes B G, Graham K, Kerr A, Roche A, Hill D, Brandt P W, Copeland J G, Mammana R, Temkin L P, Glenn W
Circulation. 1982 Nov;66(5):1034-44. doi: 10.1161/01.cir.66.5.1034.
We explored techniques that would allow the surgeon to localize coronary artery lesions demonstrated angiographically or to supplement angiographic information in patients who are undergoing coronary artery bypass procedures by intraoperative scanning of the coronary arteries using ultrasound. A 9-MHz electronically focused water-path ultrasound scanner was first used to image the coronary arteries in three anesthetized, open-chest sheep. In a subsequent study, 10 human subjects undergoing cardiac surgery for valve replacement who had normal coronary angiograms were scanned during heart surgery to provide images of normal coronary arteries. The ultrasound probe was sterilized with gas and placed directly on the beating heart by the surgeon. In the third phase of this study, 21 patients with coronary artery disease were scanned and the ultrasonic appearance of their imaged coronary lesions was compared to independently interpreted angiographic estimates of percent obstruction, with close correlation (r = 0.91). The ultrasound scan could be used to identify lesions in vessels beyond proximal occlusions, which are not visualized well angiographically, and could localize the site of lesions to determine placement of saphenous vein bypass grafts. This new technique may provide a method for evaluating coronary atherosclerotic lesions during coronary artery surgery and aid decisions regarding placement of saphenous vein grafts.
我们探索了一些技术，这些技术能让外科医生在冠状动脉搭桥手术中，通过使用超声对冠状动脉进行术中扫描，来定位经血管造影显示的冠状动脉病变，或补充血管造影信息。一台9兆赫电子聚焦水路径超声扫描仪首先被用于对三只麻醉开胸绵羊的冠状动脉进行成像。在随后的一项研究中，对10名接受心脏瓣膜置换手术且冠状动脉造影正常的心脏手术患者在心脏手术期间进行扫描，以获取正常冠状动脉的图像。超声探头经气体消毒后由外科医生直接放置在跳动的心脏上。在本研究的第三阶段，对21名冠状动脉疾病患者进行了扫描，并将其成像冠状动脉病变的超声表现与独立解读的血管造影阻塞百分比估计值进行比较，二者具有密切相关性（r = 0.91）。超声扫描可用于识别近端闭塞以外血管中的病变，这些病变在血管造影中显示不佳，并且可以定位病变部位以确定大隐静脉旁路移植的位置。这项新技术可能为冠状动脉手术期间评估冠状动脉粥样硬化病变提供一种方法，并有助于做出关于大隐静脉移植位置的决策。
