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This case from the REQUEST study illustrates how High-Frequency Ultrasound Imaging (HFUS) can be used during surgery to detect unexpected issues with the conduit to avoid complications and improve graft patency.
Dissected LIMA detected by use of HFUS
Case story
Patient information
81-year-old male, 165 cm, 73 kg, BMI 26.8, NSTEMI, unstable angina with 3-v and LM disease.
Intraoperative quality assessment with HFUS
In this case the surgeon scanned the conduits in-situ prior to grafting and discovered the issue that led to a change in the surgical plan. The plan was to perform an On-pump CABG with three targets: LIMA-LAD and SVG sequential to OM and PDA.
However, imaging of the LIMA in-situ showed a dissection of the LIMA (Video 1), enabling the surgeons to change the plan from LIMA-LAD to using SVG both to OM, PDA and LAD.
Case attachments
Click images below to view.
HFUS of LIMA showing dissection
Reference
Registry for Quality Assessment with Ultrasound Imaging and Transit-time FlowMeasurement in Cardiac Bypass Surgery
Taggart DP et al. Intraoperativetransit-time flow measurement and high-frequency ultrasound assessment incoronary artery bypass grafting. J Thorac Cardiovasc Surg. 2019; 159:1283-1292.
DOI: https://doi.org/10.1016/j.jtcvs.2019.05.087
Technology Used
Medistim MiraQ™ Cardiac System with QuickFit™ TTFM Probes and L15 High-Frequency Ultrasound Probe.
