Ultrasonographic and DSCT scan analysis of single lima versus arterial T grafts 12 years after surgery.
OBJECTIVE
The aim of this study was to investigate long-term graft outcome in patients with left internal mammary artery to left anterior descending coronary artery (LIMA-LAD) and T-grafts by ultrasonography and dual source computed tomography (DSCT) and to analyse if ultrasonography can determine graft patency.


METHODS
Thirty-two patients, 28 males, 50.8+/-8.8 years at operation, were studied. Fifteen patients with single LIMA-LAD and additional vein grafts (group I) and 17 patients with LIMA-free right internal mammary artery (FRIMA) T-grafts (group II) underwent DSCT, transthoracic ultrasonography of the LIMA and an electrocardiogram. Differences were tested with unpaired and paired t tests.


RESULTS
In group I, 4.1+/-1.1 and in group II, 4.5+/-1.1 anastomoses/patients were performed. DSCT showed three string sign LIMA (20%) grafts and six occluded venous anastomoses (13%) in group I and three (distal) string sign LIMA grafts (18%), seven occluded LIMA anastomoses (23%) and nine occluded FRIMA anastomoses (23%) in group II. Ultrasonographic variables in the proximal part of the LIMA graft did not differ between the groups. No effect was found for proximal string sign LIMA grafts in ultrasonographic graft performance.


CONCLUSIONS
Ultrasonography cannot distinguish between string sign and patent single LIMA or T-grafts nor demonstrate distal anastomosis patency in T-grafts 12 years after surgery.
Department of Cardiothoracic Surgery, Thoraxcentre, Erasmus Medical Centre, Rotterdam, Rotterdam, the Netherlands - jmhartman88@hotmail.com / j.m.hartman@erasmusmc.nl.
J
J
Hartman
B
B
Meijboom
T
T
Galema
H
H
Takkenberg
A M
AM
Schets
P
P
De Feyter
A
A
Bogers
D000328:Adult; D017023:Coronary Angiography / Q000379:methods*; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011237:Predictive Value of Tests; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency