Publication Brief Ultrasonic Assessment of Internal Thoracic Artery Flow CABG Surgery

CABG Surgery
Publication Brief
Ultrasonic Assessment of Internal Thoracic Artery Flow
in the Revascularized Heart
Division of Cardiothoracic Surgery, University of Wisconsin School of Medicine, Madison, WI
Dartmouth-Hitchcock Medical Center College, Lebanon, NH
OBJECTIVE
The purpose of the study was to investigate the clinical applicability of measuring ITA (internal thoracic
[mammary] artery) flow during on-pump coronary artery revascularization and to validate the reliability
ultrasonic transit-time measurements.
METHOD
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Arterial and venous (saphenous vein) graft flows were measured intraoperatively in 63 patients with 3
and 4 mm perivascular flowprobes and a dual-channel Transonic® clinical flowmeter (HT207).
Native free flow was measured in all patients.
Flow from the distal end of the ITA was collected in an open beaker for 30 seconds at normal pressure
after the distal end of the ITA was cut. Simultaneous ITA blood flow was measured by transit-time
ultrasound flowprobes on the skeletonized proximal end of the ITA.
SVG and ITA flows were measured during cardio-pulmonary bypass and immediately before closure of
the sternum.
RESULTS
PARAMETER
N
FLOW (ml/min)
Native Left ITA
55
7 ± 0.8
Native Right ITA
8
6 ± 1.5
Mean ITA Free Flow
63
60 ± 8
Flow measurements added ≤ 15 minutes to the total operation time.
CONCLUSION
Transit time ultrasound can accurately quantitate physiologic blood flow through an ITA graft
immediately after coronary artery bypass grafting and provides the surgeon with valuable information.
TRANSONIC® OBSERVATIONS
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This is the first paper to validate intraoperative blood flow on the internal thoracic artery during
coronary artery bypass grafting (CABG) surgery. Earlier electromagnetic flowmeters could not measure
ITA flows accurately.
Flow was validated with simultaneous measurements of proximal ITA flow and collection of distal
blood flow from the cut ITA in a beaker with a stopwatch (beaker/stopwatch method).
REFERENCES
1Canver
CC, Dame N,“Ultrasonic Assessment of Internal Thoracic Artery Graft Flow in the Revascularized Heart,” Ann Thorac Surg 1994; 58:1358. (Transonic Reference # 51V)
2Canver CC, Chanda J, “Transit-Time Ultrasound Flowmetry in CABG,” Surgical Technology International IX 2000; 227-230. (Transonic Reference
# 45V)
Canver(CV-51V-pb)RevC 2013 USltr
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