| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2004;77:1586-1592
© 2004 The Society of Thoracic Surgeons
a Heart Lung Center Utrecht, University Medical Center, Utrecht, The Netherlands
Accepted for publication October 10, 2003.
* Address reprint requests to Dr Borst, University Medical Center Utrecht (Room G02.523), Heidelberglaan 100 3584 CX, Utrecht, The Netherlands
e-mail: exp.cardio{at}hli.azu.nl
BACKGROUND: In totally endoscopic coronary artery bypass grafting the target coronary artery is difficult to locate and assess. We explored the capacity of a high-frequency epicardial ultrasound mini-transducer (Aloka, Tokyo, Japan) to endoscopically locate and assess the left anterior descending (LAD), third obtuse marginal (OM3), and right posterior descending (RDP) coronary arteries.
METHODS: In eight pigs, the LAD, OM3, and RDP were endoscopically exposed. The mini-transducer was manipulated by the "da Vinci" telemanipulation system (Intuitive Surgical, Inc, Mountain View, CA) over the unstabilized and stabilized epicardium to identify the target artery, obtain a scout scan, and both transverse and longitudinal images.
RESULTS: In both unstabilized and stabilized conditions, the LAD and RDP were identified within a median of 29 seconds. In stabilized conditions, assessment was complete in 112 seconds (92 to 205) (median with range) for the LAD and 140 seconds (54 to 197) for the RDP. Stabilization of the OM3 was required for identification (16 [5 to 60]) and assessment (111 [82 to 225]). Overall identification was correct in 23 of 24 arteries. The OM branches and RDP became fully exposed endoscopically with stroke volume (SV) and mean arterial pressure (MAP) remaining at 67% ± 11% (mean ± standard error of the mean) and 70% ± 5% of baseline values, respectively. Scanning itself did not augment the decrease in SV and MAP significantly.
CONCLUSIONS: After proper endoscopic exposure and stabilization, robot-assisted epicardial ultrasound scanning enabled endoscopic identification and assessment of major coronary arteries within a median of 169 seconds per artery. Exposure, stabilization, and scanning were accompanied by an acceptable drop in stroke volume and mean arterial pressure.
This article has been cited by other articles:
|
|
 |
|
  H. Stein, J. M. Smith, J. R. Robinson, and M. R. Katz Target vessel detection and coronary anastomosis assessment by intraoperative 12-MHz ultrasound. Ann. Thorac. Surg., September 1, 2006; 82(3): 1078 - 1084. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. P.J. Budde, P. F. A. Bakker, R. Meijer, C. Borst, and P. F. Grundeman Ultrasound Mini-Transducer with Malleable Handle for Coronary Artery Surgery Ann. Thorac. Surg., January 1, 2006; 81(1): 322 - 326. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. P.J. Budde, W. J.L. Suyker, P. T.W. Suyker, C. W.J. Verlaan, R. Meijer, C. Borst, and P. F. Grundeman Quality assessment of distal S2AS connector anastomosis by 13MHz epicardial ultrasound Eur. J. Cardiothorac. Surg., December 1, 2005; 28(6): 833 - 837. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. P.J. Budde, T. C. Dessing, R. Meijer, P. F.A. Bakker, C. Borst, and P. F. Grundeman Robot-assisted 13 MHz epicardial ultrasound for endoscopic quality assessment of coronary anastomoses Interactive CardioVascular and Thoracic Surgery, December 1, 2004; 3(4): 616 - 620. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. C. Dessing, R. P.J. Budde, R. Meijer, P. F.A. Bakker, C. Borst, and P. F. Grundeman Geometry assessment of coronary artery anastomoses with construction errors by epicardial ultrasound Eur. J. Cardiothorac. Surg., August 1, 2004; 26(2): 257 - 261. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
