Intraoperative application of power Doppler imaging: visualization of myocardial perfusion after anastomosis of left internal thoracic artery to left anterior descending coronary artery.

The purpose of this study was to determine the role of power Doppler imaging in assessing patency of coronary artery bypass graft (CABG) anastomosis. Twelve consecutive patients referred for CABG with the use of anastomosis of the internal thoracic artery to the left anterior descending coronary artery (LAD) were studied. A linear 6.5-MHz wide-band transducer was used during cardioplegic administration and reperfusion. Baseline power Doppler signals were obtained in the LAD in 11 patients, and post-CABG signals were obtained in 11 patients. In one patient the LAD was poorly visualized because of extensive calcification. In another patient the flow after bypass worsened and the graft was revised. Visualization of the LAD and internal thoracic artery grafts by epicardial intraoperative power Doppler imaging is feasible in almost all patients and allows rapid and simple intraoperative assessment of graft patency. In addition, myocardial perfusion is limited by heavily calcified coronaries.