Initial Experience with Epicardial Ultrasound Scanning in Coronary Artery Bypass Grafting

Abstract

Background: The benefits of epicardial ultrasound scanning (EUS) in coronary artery by-pass grafting (CABG) have not yet been established. The aim of this study was to evaluate the usefulness of EUS in CABG, including in the assessment of the quality of distal anasto-moses, the identification of epicardial target vessels, and the evaluation of any graft issues other than the distal anastomoses.Methods: Fifty-three patients undergoing CABG were enrolled between March 2018 and February 2019. Intraoperative EUS was performed along with transit-time flow measure-ment (TTFM). Graft evaluations were performed early (shortly after surgery) and 1 year after surgery for 53 (100%) and 47 (88.7%) patients, respectively.Results: EUS was applied to assess the quality of all distal anastomoses, 32 target ves-sels, and 2 conduit trunks. Insufficient TTFM findings were obtained for 18 grafts. However, graft revision was performed for only 3 distal anastomoses; based on the EUS findings, the remaining 15 sites were not revised. The early and 1-year overall graft patency rates were 100% (141 anastomoses) and 96.1% (122 of 127 anastomoses), respectively. All 15 of the distal anastomoses that were not revised despite insufficient TTFM results were patent at the 1-year mark.Conclusion: The routine application of EUS in CABG could be beneficial by confirming the quality of surgery and reducing unnecessary procedures.

Keywords

• coronary artery disease
• coronary artery bypass
• ultrasonography
• vascular patency