| New Procedure to Detect Intra-Muscular
and/or Intra-Fat Coronary Artery Using an Ultrasonic Flowmeter |
(Department of Cardiovascular Surgery, St. Marianna
University, School of Medicine, Kawasaki, Japan and Department
of Cardiovascular Surgery*, Ishioka Noushinkeigeka Hospital, Ishioka,
Japan)
| Keita Kikuchi |
Haruo Makuuchi |
Hiroshi Murakami |
| Takamaro Suzuki |
Takashi Ando |
Makoto Ohno |
| Hirokuni Ono |
Kiyoshi Chiba |
Shinichi Endo* |
|
Detection of the coronary artery
is usually an easy procedure in the coronary artery surgery.
However in cases with an intra-muscular and/or intra-fat coronary
artery, it requires special skill and experience. Dissection
of epicardial adipose tissue and/or muscle along the epicardial
groove is a common procedure to reach such coronary artery in
conventional CABG (C-CABG). Recently, off-pump CABG (OPCAB) has
become a standard operation, and detection of such a coronary
artery is difficult under the beating heart. Then conversion
to the C-CABG becomes necessary to avoid ventricular rupture.
We report a new procedure to easily detect such a coronary artery
in OPCAB, using an ultrasonic flowmeter used in neurosurgery.
Because the tip of the probe is small (2mm in diameter) and flexible,
its handling is quite similar to that of the micro-blade knife.
Furthermore, audiable Doppler flow sound allows detection and
dissection of the coronary artery without looking away from the
operative field to check the coronary flow. In our case, use
of the instrument enabled us to detect the anterior descending
branch of the left coronary artery which was very deep in adipose
tissue. Therefore, application of this ultrasound instrument
is beneficial in OPCAB with an intra-muscular and/or intra-fat
coronary artery.
Jpn. J. Cardiovasc. Surg. 34: 159-161 (2005) |
|
