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Measurement of coronary sinus flow using transesophageal echocardiography in patients undergoing coronary artery
Insights
Transesophageal echocardiography (TEE) successfully measured coronary sinus blood flow during coronary artery bypass graft (CABG) surgery. Post-surgery blood flow velocity increased significantly in patients without new wall motion abnormalities.
Area of Science:
- Cardiovascular Surgery
- Echocardiography
- Hemodynamics
Background:
- Coronary artery bypass graft (CABG) surgery is a common procedure.
- Monitoring blood flow during CABG is crucial for patient outcomes.
- Transesophageal echocardiography (TEE) offers a potential method for intraoperative monitoring.
Purpose of the Study:
- To measure coronary sinus blood flow during CABG using TEE.
- To assess the feasibility of using TEE for intraoperative evaluation of CABG.
Main Methods:
- Prospective study involving 31 adult patients undergoing elective CABG.
- Coronary sinus blood flow velocity and hemodynamic variables were measured using TEE.
- Measurements were taken before and after cardiopulmonary bypass (CPB).
Main Results:
- Complete measurements were obtained from 29 subjects (94%) and 28 patients (90%).
- In patients without new regional wall motion abnormalities (n=23), peak velocity and velocity time integral (VTI) of coronary sinus blood flow significantly increased post-CPB compared to pre-CPB.
- In patients with new regional wall motion abnormalities (n=5), peak velocity and VTI did not significantly increase post-CPB.
Conclusions:
- Pulse-Doppler TEE can effectively measure coronary sinus flow velocity during CABG.
- Coronary sinus blood flow velocity increased significantly post-CPB in patients without new wall motion abnormalities.
- This preliminary study demonstrates the feasibility of intraoperative clinical evaluation of CABG using TEE.
Study Objective:
To measure coronary sinus blood flow during coronary artery bypass graft (CABG) with transesophageal echocardiography (TEE).
Design:
Prospective study.
Setting:
Elective cardiac surgery at a university hospital.
Patients:
Thirty-one ASA physical status III and IV adult patients free of significant coexisting disease and undergoing CABG.
Intervention:
We measured coronary sinus blood flow velocity by using TEE and hemodynamic variables, before and after cardiopulmonary bypass (CPB) and after CPB.
Measurements And Main Results:
We obtained a complete set of control measurements for 29 subjects (94%) and a complete set of post-CPB measurements in 28 patients (90%). In the normal group, peak velocity, and velocity time integral (VTI) of coronary sinus blood flow in the post-CPB period increased significantly compared with the pre-CPB period with CABG (n = 23). In the group of new regional wall motion abnormalities in the post-CPB period, peak velocity and VTI of coronary sinus blood flow in the post-CPB period did not increase significantly compared with the pre-CPB period by CABG (n = 5).
Conclusions:
We were able to measure the coronary sinus flow velocity by pulse-Doppler TEE during CABG. The peak velocity and VTI of coronary sinus blood flow in the post-CPB period increased significantly compared with in the pre-CPB period by CABG. The results of this preliminary study show the feasibility of clinical evaluation of CABG intraoperatively.
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