title: Ultrasound mini-transducer with malleable handle for coronary artery surgery.
abstract: OBJECTIVE
  A 13 MHz epicardial ultrasound mini-transducer (15 x 9 x 6 mm) with a custom made malleable handling tool was evaluated to assess the coronary artery and anastomosis on all sides of the heart.
  
  
  METHODS
  On indication, in 8 patients undergoing coronary artery bypass surgery on the arrested heart, 8 coronary arteries as well as 27 coronary anastomoses were scanned.
  
  
  RESULTS
  The malleable handle was easily adjusted, and all sides of the heart were accessible for scanning with the mini-transducer. Based on intraoperative scanning, the anastomotic site was altered (n = 4), an additional coronary artery was grafted (n = 2), and the left anterior descending coronary artery was identified after incorrect conventional selection of the diagonal branch (n = 1). No anastomosis construction errors were detected. In one anastomosis, a calcified plaque was seen in the outflow corner.
  
  
  CONCLUSIONS
  The epicardial ultrasound mini-transducer with its malleable handle allowed successful visualization and assessment of the coronary arteries and anastomoses on all sides of the heart. Ultrasound information greatly aided in intraoperative decision making that resulted in anastomotic site changes and prevented grafting of the wrong vessel.
authors.affiliation: Heart Lung Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Ricardo P J
authors.initials: RP
authors.lastname: Budde
authors.forename: Patricia F A
authors.initials: PF
authors.lastname: Bakker
authors.forename: Rudy
authors.initials: R
authors.lastname: Meijer
authors.forename: Cornelius
authors.initials: C
authors.lastname: Borst
authors.forename: Paul F
authors.initials: PF
authors.lastname: Gründeman
mesh_terms: D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D018618:Echocardiography, Doppler, Color / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D007431:Intraoperative Complications / Q000517:prevention & control; D008904:Miniaturization; D010496:Pericardium / Q000000981:diagnostic imaging; D012501:Saphenous Vein / Q000637:transplantation; D014159:Transducers; D016042:Transplantation, Heterotopic; D018084:Ultrasonography, Interventional / Q000295:instrumentation*