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J Thorac Cardiovasc Surg 2002;124:785-789
© 2002 The American Association for Thoracic Surgery

Evolving Technology (ET)

Epicardial 10-MHz ultrasound in off-pump coronary bypass surgery: A clinical feasibility study using a minitransducer

From the Department of Cardiology, Heart-lung Center Utrecht, University Medical Center,^a Utrecht, and St Antonius Hospital,^b Nieuwegein, The Netherlands.

Received for publication Aug 6, 2001. Revisions requested Oct 31, 2001; revisions received Nov 15, 2001. Accepted for publication Dec 27, 2001. Address for reprints: Cornelius Borst, MD, PhD, Professor of Experimental Cardiology, University Medical Center Utrecht (Room G02.523), PO Box 85500, 3508 GA Utrecht, The Netherlands (E-mail: c.borst{at}hli.azu.nl).

Objective: In off-pump coronary artery bypass surgery, both plaque and calcifications and torrential back flow from side branches in the isolated coronary segment may hamper coronary anastomosis suturing. The epicardial application of an ultrasonographic minitransducer with color Doppler scanning modality was studied in off-pump coronary surgery to detect septal perforating side branches; to assess the location, size, and quality of the coronary vessel; and to visualize the anastomotic orifice before chest closure.
Methods: Thirteen patients were selected for multivessel off-pump bypass. The investigation was limited to the left anterior descending coronary artery. The anastomotic target site was chosen on preoperative and intraoperative findings. The conventionally designated site was scanned with a novel 10-MHz ultrasonographic miniprobe (15 x 6 x 9 mm) that fitted in between the cardiac stabilizer pods.
Results: In 11 of the 13 cases, the course of the left anterior descending coronary artery could be properly identified. In 3 cases detection of perforating side branches caused a change in anastomotic site. A sufficiently dry field was obtained in all 13 cases. In 11 cases the anastomotic orifice was adequately visualized.
Conclusion: During off-pump coronary surgery, 10-MHz ultrasonographic images from a minitransducer aided in the intraoperative choice of anastomotic site.

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