Coronary artery bypass grafting on the beating heart evaluated with integrated backscatter.
BACKGROUND
In beating heart coronary artery bypass grafting (CABG) the effect of ischemic insult during coronary occlusion could not be evaluated immediately. Using transesophageal echocardiography, myocardial performance can be evaluated with analysis of integrated backscatter.


METHODS
In 15 beating heart CABGs, cyclic variation (CV) of integrated backscatter of the anterior wall before, during, and after the left internal thoracic artery to left anterior descending (LAD) branch anastomosis was measured with transesophageal echocardiography. The patients were divided into two groups according to collateral vessels status (good collateral group n = 6, poor collateral group n = 9).


RESULTS
In all patients, CV increased significantly after revascularization (8.56+/-2.50 to 11.47+/-3.32 dB, p < 0.0001). During LAD occlusion, significant decrease in CV was found in patients who had poor collateral arteries. At 15 minutes of LAD occlusion, CV decreased from the preocclusion value of 7.51+/-2.21 to 3.23+/-4.03 dB (p < 0.01).


CONCLUSIONS
Measurement of CV can detect the ischemic insult during coronary occlusion and the effect of revascularization in beating heart CABG.
Imasaka
K
K
Department of Cardiovascular Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Morita
S
S
Nagano
I
I
Masuda
M
M
Tominaga
R
R
Yasui
H
H
D000368:Aged; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000379:methods*; D017548:Echocardiography, Transesophageal; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010507:Periodicity