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Ann Thorac Surg 2000;70:1049-1053
© 2000 The Society of Thoracic Surgeons

Supplement: cardiothoracic techniques & technologies

Coronary artery bypass grafting on the beating heart evaluated with integrated backscatter

Kenichi Imasaka, MDa, Shigeki Morita, MDa, Ichiro Nagano, MDa, Munetaka Masuda, MDa, Ryuji Tominaga, MDa, Hisataka Yasui, MDa

a Department of Cardiovascular Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Address reprint requests to Dr Morita, Department of Cardiovascular Surgery, Faculty of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan
e-mail: morita{at}heart.med.kyushu-u.ac.jp

Presented at the Sixth Annual Cardiothoracic Techniques and Technologies Meeting 2000, Ft Lauderdale, FL, Jan 27–29, 2000.

Background. In beating heart coronary artery bypass grafting (CABG) the effect of ischemic insult during coronary occlusion could not be evaluated immediately. Using transesophageal echocardiography, myocardial performance can be evaluated with analysis of integrated backscatter.

Methods. In 15 beating heart CABGs, cyclic variation (CV) of integrated backscatter of the anterior wall before, during, and after the left internal thoracic artery to left anterior descending (LAD) branch anastomosis was measured with transesophageal echocardiography. The patients were divided into two groups according to collateral vessels status (good collateral group n = 6, poor collateral group n = 9).

Results. In all patients, CV increased significantly after revascularization (8.56 ± 2.50 to 11.47 ± 3.32 dB, p < 0.0001). During LAD occlusion, significant decrease in CV was found in patients who had poor collateral arteries. At 15 minutes of LAD occlusion, CV decreased from the preocclusion value of 7.51 ± 2.21 to 3.23 ± 4.03 dB (p < 0.01).

Conclusions. Measurement of CV can detect the ischemic insult during coronary occlusion and the effect of revascularization in beating heart CABG.






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