Ann Thorac Surg 2008;85:2161-2162. doi:10.1016/j.athoracsur.2008.01.026
© 2008 The Society of Thoracic Surgeons
Correspondence
Thermal Coronary Angiography
Francis Robicsek, MD, PhD
Department of Cardiovascular and Thoracic Surgery, Carolinas Medical Center, 1001 Blythe Blvd, No. 300, Charlotte, NC 28203
(Email: francis.robicsek{at}carolinashealthcare.org).
To the Editor:
One can only agree with the conclusions of the recent article, "New Method of Thermal Coronary Angiography for Intraoperative Patency Control in Off-Pump and On-Pump Coronary Artery Bypass Grafting" by Iwahashi and colleagues [1], that this "diagnostic modality does not interfere with the surgical procedures, is noninvasive, and can be both quickly and easily performed." To this we may add that in our early experiments [2], it also proved to be a valuable tool to image changes in the total coronary perfusion.
As a practical application of coronary thermography is concerned, however, our experiences are different than those of the authors. Although the method may indeed be able to demonstrate the patency of the graft-to-coronary artery anastomosis about as well as a simple thermoprobe [3], we found it disappointing in detecting less than critical (<75%) anastomotic narrowing [4]. Measurements on the posterolateral and posterior aspects on the heart were especially unreliable, especially in the presence of epicardial fat. For similar reasons, other institutions [5] after initial enthusiasm of coronary thermal angiography also discontinued its application.
We respectfully disagree with the authors that coronary thermal angiography is either new or that it has an acceptable sensitivity to detect important morphologic changes short of more than critical narrowing.
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References
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- Iwahashi H, Tashiro T, Morishige N, et al. New method of thermal coronary angiography for intraoperative patency control in off-pump and on-pump coronary artery bypass grafting Ann Thorac Surg 2007;84:1504-1507.[Abstract/Free Full Text]
- Robicsek F, Masters TN, Niesluchowski W, Born GVR. The effects of adenosine upon the coronary circulation studied by thermography Vasc Surg 1984;18:135-140.
- Robicsek F. A simple test to determine the efficiency of mammary artery grafts during operation Ann Thorac Surg 1985;39:388-389.[Abstract]
- Robicsek F, Masters TN, Svenson RH, et al. The application of thermography in the study of coronary blood flow Surgery 1978;84:858-864.[Medline]
- Mohr FW, Matloff J, Grundfest W, et al. Thermal coronary angiography: a method for assessing graft patency and coronary anatomy in coronary bypass surgery Ann Thorac Surg 1989;47:441-449.[Abstract]
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