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J Thorac Cardiovasc Surg 1999;117:912-917
© 1999 Mosby, Inc.

SURGERY FOR ADULT CARDIOVASCULAR DISEASE

ON-LINE ASSESSMENT OF REGIONAL VENTRICULAR WALL MOTION BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY WITH COLOR KINESIS DURING MINIMALLY INVASIVE CORONARY ARTERY BYPASS GRAFTING

From the Departments of Surgery^a and Anesthesiology,^b Toyama Medical and Pharmaceutical University, Toyama, Japan.

Received for publication Sept 9, 1998. Revisions requested Nov 6, 1998. Revisions received Jan 11, 1999. Accepted for publication Jan 12, 1999. Address for reprints: Keiju Kotoh, MD, Department of Surgery, Toyama Medical and Pharmaceutical University, 2630 Sugitani, Toyama 930-0194, Japan.

Objective: Our objective was to determine the changes in regional ventricular wall motion during minimally invasive direct coronary artery bypass grafting by color kinesis using transesophageal echocardiography.
Methods: Minimally invasive coronary artery bypass grafting was performed in 34 patients, during which transesophageal echocardiography was used. Thirteen patients had isolated disease of the left anterior descending artery. Regional ventricular wall motion was analyzed by color kinesis with the SONOS 2500 transesophageal echocardiograph (Hewlett-Packard Co, Andover, Mass). On-line assessment of regional wall motion was continued during the operation.
Results: Wall motion abnormalities during ischemia were present in 4 cases, left ventricular mid-anterior hypokinesis in 3 cases, and left ventricular apical-lateral hypokinesis in 1 case. In all cases, wall motion was maintained after bypass. In patients with total coronary occlusion, changes in wall motion did not occur during anastomosis.
Conclusions: Color kinesis allowed us to evaluate the change in regional ventricular wall motion induced by myocardial ischemia during minimally invasive coronary artery bypass grafting both objectively and quantitatively.

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