GASTROEPIPLOIC ARTERY COROLLARY BYPASS GRAFT - NONINVASIVE PATENCY EVALUATION USING COLOR AND DUPLEX-DOPPLER ULTRASONOGRAPHY

Objective: Color and duplex Doppler ultrasound and digital subtraction angiography were compared for the evaluation of graft patency of the gastroepiploic artery (GEA). Methods: In 77 observations, ultrasound a nd digital subtraction angiography were compared. The coronary resista nce index (cRI) was defined as the maximal systolic flow velocity minu s the maximal diastolic flow velocity, divided by the maximal systolic flow velocity. On digital subtraction angiography, the graft was cons idered patent, occluded, or patent but non-functional. Grafts were def ined as non-functional when they had a diameter of less than 5F with t he absence of opacification of the native coronary artery. Results: Of the 77 observations, 64 GEAs were patent angiographically, three were occluded and ten grafts were considered as patent but non-functional. Using color and duplex ultrasound, the GEA was identified in 65 out o f 77 observations. There were no cases of false positive visualization of the GEA. All sonographically detected non-functional grafts (n = 7 ) had a cRI of greater than 0.60. When the non-visualized grafts are c onsidered either non-functional or occluded, a cut-off value for a cRI of 0.60 results in a sensitivity and specificity of 100 and 75%, resp ectively. Conclusion: We propose ultrasound as a primary screening too l for evaluating graft patency. While color Doppler is a suitable tech nique for graft visualization, spectral analysis with the calculation of a cRI is required for functional evaluation. Copyright (C) 1997 Els evier Science B.V.