冠脉搭桥术后桥管的超声检查方法研究

Transthoracic ultrasonography of coronary artery bypass grafts after operation

目的探讨经胸超声检查冠脉搭桥术后桥管的显像方法及血流状态。方法采用经胸超声冠脉血流显像与高频血管显像相结合对左乳内动脉原位转流至左前降支、大隐静脉-右冠状动脉及大隐静脉-左回旋支桥管进行检查。结果左乳内动脉桥管、大隐静脉-右冠状动脉及大隐静脉-左回旋支桥管显示率分别为100%、93.75%和20%。左乳内动脉及大隐静脉桥管的血流均为舒张期为主的双期血流;左乳内动脉桥管的舒张期血流速度及流速时间积分大于大隐静脉桥管(P<0.05)。结论经胸超声是术后桥管检查的较好方法,可用于无创的评估术后桥管血流状态。

Objective To investigate the methodology of transthoracic ultrasonography assessing coronary artery bypass grafts （CABG） and the flow status in grafts. Methods The left internal mammary artery grafts to left anterior descending artery, great saphenous vein grafts to the right coronary artery and great saphenous vein grafts to the circumflex artery were detected using high frequency flow imaging combined with color Doppler coronary flow imaging. Results All the left internal mammary artery grafts and 93.75 % great saphenous vein grafts to the right coronary artery had been detected successfully. The percent of twenty of great saphenous vein grafts to the circumflex artery could be imaged. The hemodynamic pattern in all grafts represented diastolic dominant after the operation. The diastolic peak velocity （Vd） and diastolic velocity time integral（VTId） in saphenous vein grafts was significantly less than in left internal mammary artery grafts （P〈0.05）. Conclusion Transthoracic ultrasonography is a preferable method in detecting bypass grafts after operation. It can provide noninvasive assessment of the hemodynamic characteristic of CABG.