Hubert Stein, BS, BME, John Michael Smith, MD, John R

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Presentation transcript:

Target Vessel Detection and Coronary Anastomosis Assessment by Intraoperative 12- MHz Ultrasound Hubert Stein, BS, BME, John Michael Smith, MD, John R. Robinson, MD, Marc R. Katz, MD The Annals of Thoracic Surgery Volume 82, Issue 3, Pages 1078-1084 (September 2006) DOI: 10.1016/j.athoracsur.2006.03.040 Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 The left internal mammary artery (LIMA) identification (patient WRP). Vessel path not visible for the surgeon under direct vision due to fascia and muscle tissue covering the LIMA. (a) Longitudinal scan with color flow Doppler showing LIMA embedded in tissue (red) with a side branch (blue). (b) Transverse scan of the LIMA with color Doppler flow. (c) LIMA course can be followed with transverse scan past the bifurcation (blue). The Annals of Thoracic Surgery 2006 82, 1078-1084DOI: (10.1016/j.athoracsur.2006.03.040) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Left anterior descending coronary artery (LAD) detection (patient JKR). (a) Longitudinal scan of anticipated anastomotic target on LAD. (b) Longitudinal scan with color flow Doppler at “clean” coronary segment as the new anastomosis target site. Septal perforator branch (SP) was identified before arteriotomy. (*Plaque and calcification in the artery that have not been palpable and were not visible under direct vision and on preoperative angiography; S = stenosis from plaque.) The Annals of Thoracic Surgery 2006 82, 1078-1084DOI: (10.1016/j.athoracsur.2006.03.040) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Anastomosis assessment (patient RFL). (a) Longitudinal scan of the anastomosis, no construction errors or similar visible. (b) Same scan with color Doppler flow showing good flow through anastomotic orifice from the internal mammary artery (IMA) into the left anterior descending coronary artery (LAD). The Annals of Thoracic Surgery 2006 82, 1078-1084DOI: (10.1016/j.athoracsur.2006.03.040) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions