[Visualization of internal mammary artery bypass graft flow using a linear color flow mapping system with a convex...

To evaluate noninvasively the patency of aortocoronary bypass grafts using the left internal mammary artery (LIMAG), color flow mapping Doppler echocardiography was performed in 23 consecutive patients. There were 22 males and one female. The average number of involved coronary arteries per patient was 2.5 +/- 0.6. The average number of bypassed graft anastomoses was 2.7 +/- 0.9, including 22 isolated LIMAG and one sequential LIMAG. The color flow mapping system used was a linear type 2-D Doppler system (Aloka SSD350) with a convex type transducer. Clear color flow visualization of LIMAG flow was obtained in nine of the 23 patients (39%) studied, with an average peak diastolic velocity of 22.5 +/- 8.7 cm/sec and an average systolic peak velocity of 12.6 +/- 5.7 cm/sec. The coronary angiograms of eight patients were obtained within two weeks after the echocardiographic examinations which demonstrated good graft patency in all LIMAG. Color flow visualization of LIMAG was obtained in four of the eight patients (50%). Although the detection rate was limited, LIMAG flow could be clearly visualized in nearly half the cases studied with stable reproducibility from the transcutaneous echo window. Thus, this technique can be a useful diagnostic means for long-term follow-up of LIMAG and for investigating coronary circulation in the future.