INTRAOPERATIVE CORONARY ANGIOSCOPY - TECHNIQUE AND RESULTS - A STUDY OF 38 PATIENTS

Over a period of 11 months, 38 patients submitted to coronary artery r evascularization underwent intraoperative angioscopy of the coronary a rteries and internal thoracic arteries. Fifty-nine lesions were observ ed, but only 31 stenoses responsible for coronary insufficiency were o bserved (33%). Forty-four distal anastomoses were explored (47%) but t en of these explorations were incomplete. None revealed technical fail ure of the anastomosis. Thirteen harvested left internal mammary arter ies were explored. One of the explorations led to rejection of the gra ft due to an intimal fracture. Some tiny intimal flaps were observed i n our experience, as in others. Although the iatrogenic origin of thes e lesions in relation to the introduction of the angioscope is obvious , it does not seem to influence the outcome of the operation. In our o pinion, two main fields appear to be developing in coronary angioscopy : preoperative assessment of the quality of internal thoracic artery g rafts, and control of distal graft anastomoses. The flexibility of the angioscopes and of the leading catheters must be improved to minimize the risk of arterial wall traumatic lesions.