Minimally invasive mammary artery Doppler flow velocity evaluation in minimally invasive coronary operations
Minimally invasive mammary artery Doppler flow velocity evaluation in minimally invasive coronary operations
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DOI：
10.1016/s0003-4975(98)00520-7
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发表时间：
1998-10-01
影响因子：
4.6
通讯作者：
Vitolla, G
中科院分区：
文献类型：
--
作者：
Calafiore, AM;Gallina, S;Vitolla, G
背景在Azoulay动作（患者被动抬起双腿，并由患者主动维持）过程中对左乳内动脉多普勒血流速度进行评估，可增加左前小切口手术后左乳内动脉-左前降支冠状动脉移植术后吻合质量的信息。100例患者在静息和Azoulay操作期间进行了早期术后血管造影和多普勒血流速度评估。记录所有患者的收缩期峰值和平均速度、舒张期峰值和平均速度以及舒张期峰值和平均速度与收缩期速度的比值。在95例无限制性管道或吻合的患者中，在Azoulay操作期间，舒张期峰值和平均收缩期流速比增加;除1例患者外，所有患者均显示至少一个比值等于或大于1。在4例限制性管道或吻合术患者中，Azoulay动作时舒张期峰值与收缩期平均流速比始终小于1。在管道阻塞的患者中，这些比值小于0.6。阿祖莱动作期间峰值和平均舒张期与收缩期速度比小于1表明管道或吻合口故障。如果我们将血管造影的对照限于这些患者，很可能不会遗漏病理性吻合或管道。(Ann Thorac Surg 1998;66：1236-41）（C）1998年，胸外科医师协会。
Background. Left internal mammary artery Doppler now velocity assessment during the Azoulay maneuver (patient's legs are passively lifted up and actively maintained by the patient) can increase the information on the anastomosis quality after left internal mammary artery to left anterior descending coronary artery grafting after the left anterior, small thoracotomy operation.Methods. One hundred patients had an early postoperative angiography and a Doppler now velocity assessment at rest and during the Azoulay maneuver. Peak and mean systolic velocities, peak and mean diastolic velocities, and peak and mean diastolic to systolic velocity ratios were recorded in all patients.Results. In 95 patients with no restrictive conduit or anastomosis, peak and mean diastolic to systolic velocity ratios increased during the Azoulay maneuver; all but 1 patient showed at least one ratio equal to or greater than 1. In 4 patients with restrictive conduit or anastomosis, peak and mean diastolic to systolic velocity ratios were always less than 1 during the Azoulay maneuver. In the patient with an occluded conduit these ratios were less than 0.6.Conclusions. Peak and mean diastolic to systolic velocity ratios less than 1 during the Azoulay maneuver are suggestive of conduit or anastomosis malfunction. If we limit the angiographic controls to these patients, it is very likely that a pathologic anastomosis or conduit will not be missed. (Ann Thorac Surg 1998;66:1236-41) (C) 1998 by The Society of Thoracic Surgeons.