[Intraoperative evaluation of the function of the saphenous vein as coronary graft, visualized by myocardial contrast...

The assessment of area at risk of saphenous vein graft occlusion is an unsolved problem. We studied myocardial perfusion with contrast echocardiography in 13 patients undergoing coronary surgery. The left ventricle was imaged in the transgastric short axis view at midpapillary muscle level. The myocardial distribution area of 21 saphenous vein grafts was measured by injecting 0.2-0.5 cc of sonicated 5% albumin microspheres directly in the graft, early after weaning from cardiopulmonary bypass. Percent left ventricular area opacification was calculated for each graft injection: right coronary (N = 8) 21 +/- 7%, marginal branch (N = 10) 17 +/- 5%, left anterior descending and diagonal branch (N = 3) 41 +/- 4%. Myocardial systolic wall thickening was not effected by contrast injection (preinjection 45 +/- 12% vs postinjection 46 +/- 7%, p = NS). No local or systemic side effects were encountered.

myocardial contrast echocardiography is a safe and useful method to measure the area at risk for saphenous vein graft occlusion.