Gastroepiploic artery coronary bypass graft: non-invasive patency evaluation using color and duplex Doppler ultrasonography

• Published in: European journal of cardio-thoracic surgery 1997-01, Vol.11 (1), p.134-139
• Main Authors: GRYSPEERDT, S, VAN HOE, L, MERTENS, L, MARCHAL, G, STOCKX, L, BAERT, A. L, SERGEANT, P
• Format: Article
• Language: English
• Subjects: Adult; Aged; Angiography, Digital Subtraction; Arteries - transplantation; Biological and medical sciences; Blood Flow Velocity - physiology; Cardiology. Vascular system; Coronary Angiography; Coronary Artery Bypass - methods; Coronary Disease - diagnostic imaging; Coronary Disease - surgery; Coronary heart disease; Echocardiography, Doppler, Color; Female; Follow-Up Studies; Graft Occlusion, Vascular - diagnostic imaging; Heart; Humans; Male; Medical sciences; Middle Aged; Postoperative Complications - diagnostic imaging; Sensitivity and Specificity; Signal Processing, Computer-Assisted; Ultrasonography, Doppler, Duplex; Vascular Resistance
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/S1010-7940(96)01076-7

OBJECTIVE: Color and duplex Doppler ultrasound and digital subtractionangiography were compared for the evaluation of graft patency of thegastroepiploic artery (GEA). METHODS: In 77 observations, ultrasound anddigital subtraction angiography were compared. The coronary resistanceindex (cRI) was defined as the maximal systolic flow velocity minus themaximal diastolic flow velocity, divided by the maximal systolic flowvelocity. On digital subtraction angiography, the graft was consideredpatent, occluded, or patent but non-functional. Grafts were defined asnon-functional when they had a diameter of less than 5F with the absence ofopacification of the native coronary artery. RESULTS: Of the 77observations, 64 GEAs were patent angiographically, three were occluded andten grafts were considered as patent but non-functional. Using color andduplex ultrasound, the GEA was identified in 65 out of 77 observations.There were no cases of false positive visualization of the GEA. Allsonographically detected non-functional grafts (n = 7) had a cRI of greaterthan 0.60. When the non-visualized grafts are considered eithernon-functional or occluded, a cut-off value for a cRI of 0.60 results in asensitivity and specificity of 100 and 75%, respectively. CONCLUSION: Wepropose ultrasound as a primary screening tool for evaluating graftpatency. While color Doppler is a suitable technique for graftvisualization, spectral analysis with the calculation of a cRI is requiredfor functional evaluation.