[Intraoperative visualization of coronary arteries using two-dimensional echocardiography]

Area of Science:

• Cardiovascular Surgery
• Medical Imaging
• Diagnostic Ultrasound

Context:

• Coronary artery bypass grafting (CABG) is a critical procedure for treating coronary artery disease.
• Intraoperative assessment of coronary vessels is essential for successful surgical outcomes.
• Limitations exist in current imaging modalities for detailed intraoperative coronary artery evaluation.

Purpose:

• To evaluate the feasibility and utility of intraoperative ultrasonic visualization of coronary arteries.
• To assess the effectiveness of high-frequency micro-transducer ultrasound in imaging coronary vessels during surgery.
• To determine if ultrasound can identify lesions, guide bypass grafting, and evaluate graft patency.

Summary:

• High-frequency wide-band micro-transducer ultrasound (3.5-9.0 MHz) was employed for intraoperative visualization of coronary arteries in dogs and human patients.
• The technique successfully imaged coronary arteries from the epicardium, including occluded segments, in animal models.
• Clinically, ultrasound aided in detecting coronary arteries, visualizing lesions missed by angiography, determining bypass graft sites, assessing distal graftability, and observing post-procedure effects in patients undergoing cardiac and bypass surgery.

Impact:

• Intraoperative ultrasound provides valuable real-time imaging of coronary arteries, improving surgical decision-making during bypass procedures.
• This technique enhances the ability to identify and characterize coronary artery lesions and assess bypass graft integrity.
• Ultrasonic visualization offers a complementary tool to angiography for comprehensive intraoperative evaluation of coronary vessels.