Intraoperative application of power Doppler imaging: Visualization of myocardial perfusion after anastomosis of left internal thoracic artery to leftanterior descending coronary artery

The purpose of this study was to determine the role of power Doppler imagin g in assessing patency of coronary artery bypass graft (CABG) anastomosis. Twelve consecutive patients referred for CABG with the use of anastomosis o f the internal thoracic artery to the left anterior descending coronary art ery (LAD) were studied. A linear 6.5-MHz wideband transducer was used durin g cardioplegic administration and reperfusion. Baseline power Doppler signa ls were obtained in the LAD in 11 patients, and post-CABG signals mere obta ined in 11 patients. In one patient the LAD was poorly visualized because o f extensive calcification. In another patient the flow after bypass worsene d and the graft was revised. Visualization of the LAD and internal thoracic artery grafts by epicardial intraoperative power Doppler imaging is feasib le in almost all patients and allows rapid and simple intraoperative assess ment of graft patency. In addition, myocardial perfusion is limited by heav ily calcified coronaries.