Dissected LIMA: detected by use of HFUS

Case

This case 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.

Patient Information

81-year-old male, 165 cm, 73 kg, BMI 26.8, NSTEMI, Unstable angina with 3-v and LM disease.

Intraoperative

In this case from the REQUEST Study, 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, enabling the surgeons to change the plan from LIMA-LAD to using SVG both to OM, PDA and LAD.

Reference

Reference: Taggart et al. JTCVS 2020;159:1283-92. https://www.jtcvs.org/article/S0022-5223(19)31581-8/fulltext

Case Attachments

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