Preoperative vein mapping for coronary artery bypass operations

Area of Science:

• Vascular Surgery
• Medical Imaging

Background:

• Coronary artery bypass grafting (CABG) frequently utilizes the greater saphenous vein (GSV) as a conduit.
• Accurate preoperative assessment of the GSV is crucial for successful graft harvesting and patient outcomes.

Purpose of the Study:

• To evaluate the accuracy and utility of high-resolution, real-time ultrasonographic imaging for preoperative mapping of the GSV in patients undergoing CABG.
• To assess the correlation between ultrasound measurements and actual vein dimensions, and to identify potential variations or diseases.

Main Methods:

• One hundred patients scheduled for CABG underwent preoperative lower extremity ultrasound to image the GSV.
• Vein diameters were measured at four specific locations using ultrasound and marked on the skin.
• Intraoperative measurements of harvested veins were compared to preoperative ultrasound findings.

Main Results:

• Ultrasound mapping demonstrated a close correlation between mapped and in situ vein diameters.
• Distended vein diameter was approximately 1.5 mm larger than mapped diameter.
• The technique correctly predicted major branches or duplications in 11 patients and venous disease in 13 patients, influencing surgical site selection in 13 cases.

Conclusions:

• Preoperative ultrasonographic vein mapping is a simple, accurate, and noninvasive method for imaging the GSV.
• This technique effectively identifies venous anomalies and disease, and accurately predicts the vein's course, thereby aiding surgical planning for CABG.