Intraoperative epicardial ultrasound probe for visualization of embedded coronary arteries: A novel approach

Sudarshan Setty, Ricardo Bello, Jonathan D. Leff

Research output: Contribution to journalArticle

Abstract

The identification of coronary anatomy at the time of cardiac revascularization can be problematic. Preoperative studies (ie, coronary angiography) can aid in the mapping of the coronary anatomy. However, there remain a select few patients with intramyocardial coronaries that provide challenges for surgical dissection during revascularization. Probing the visible portion of the coronary artery, intraoperative cine angiography, thermal angiography, and epicardial Doppler probes have been used to identify the coronary anatomy intraoperatively. Aggressive surgical maneuvers can result in damage and increased time on cardiopulmonary bypass. Previous studies have used epicardial echocardiography on patients undergoing off-pump coronary artery bypass grafting. We report 2 cases in patients undergoing cardiac revascularization on cardiopulmonary bypass where the use of a high-frequency epicardial ultrasound probe facilitated the identification of the embedded coronary arteries. We describe a technique of using antegrade and retrograde cardioplegia administration sequentially to locate the coronary arteries. Easy availability and familiar technology make the epicardial Doppler probe an attractive tool for the identification of embedded coronary arteries.

Original languageEnglish (US)
Pages (from-to)71-73
Number of pages3
JournalSeminars in Cardiothoracic and Vascular Anesthesia
Volume18
Issue number1
DOIs
Publication statusPublished - Mar 2014

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Keywords

  • cardiac surgery
  • cardiopulmonary bypass
  • coronary artery bypass grafting
  • coronary artery bypass surgery
  • intraoperative assessment

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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