Intraoperative echocardiographic visualization of coronary arteries, before and after aorto-coronary bypass grafting

  • James Likungu
  • H. Murdy
  • G. Quade
  • P. Kirchhoff


While angiography remains the standard evaluation method for the visualisation of coronary artery anatomy and morphology, the angiographic findings in patients referred for surgical treatment of coronary artery disease (CAD) often do not totally answer questions related to surgical management. We therefore explored a high-frequency ultrasonic technique that allows the surgeon to localize coronary artery lesions not demonstrated angiographically, such as the distribution of coronary artery calcification in myocardial vessels buried in fat or obscured by epicardial scarring frequently observed in patients who had previously been operated upon.

Coronary arteries of 81 patients were investigated intraoperatively. Stenotic arteriosclerotic or fibrotic lesions of the arterial wall could be easily seen. This technique provides additional information to preoperative angiograms, especially in locating major coronary arteries that lie intramyocardially, or those deeply buried in fat.

Intraoperative coronary artery dilatation procedures could be followed and the effects determined by measuring pre- and postoperative diameters.

Key words

intraoperative echocardiography high frequency ultrasonography coronary artery disease intraoperative balloon dilatation 


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  1. 1.
    Kuhnen R, Grube E, Likungu J, Lüderitz B. Intraoperative Darstellung der Koronararterien: Messungen von Blutflussparametern mit Hilfe des DUPLEX-Systems. Kardiologie 1987; 76 (Suppl 1): 61.Google Scholar
  2. 2.
    Sahn DJ, Barratt-Boyes BC, Graham K, Kerr A, Roche A, Hill D, Brandt PWT, Copeland JG, Mammana R, Temkin LP, Glenn W. Ultrasonic imaging of the coronary arteries in open-chest humans: Evaluation of coronary atherosclerotic lesions during cardiac surgery. Circulation 1982; 66: 1034–1044.PubMedGoogle Scholar
  3. 3.
    Fisk RL, Brooks CH, Sandhu G, Bates PD. Expeditious location of the embedded proximal left anterior descending coronary artery. Ann Thorac Surg 1980; 29 (5): 480–482.PubMedGoogle Scholar
  4. 4.
    Robinson G. Location of proximal left anterior descending coronary artery. Ann Thorac Surg 1972; 15: 299–300.Google Scholar
  5. 5.
    Hiratzka LF, McPherson DD, Brand B, Lamberth Jr WC, Marcus ML, Kerber RE. Intraoperative high-frequency epicardial echocardiography in coronary revascularisation: Locating deeply embedded coronary arteries. Ann Thorac Surg 1986; 42: 59–511.Google Scholar
  6. 6.
    Hiratzka LF, McPherson DD, Lamberth W, Brandt B, Armstrong ML, Hunt M, Kieso R, Megan MD, Tompkins PK, Marcus ML, Kerber R. Intraoperative evaluation of coronary artery bypass graft anastomoses using high frequency epicardial echocardiography. Circulation 1985; 72 (Suppl 3): 130 (Abstract).PubMedGoogle Scholar
  7. 7.
    Coelho JCU, Sigel B, Flanigan DP, Schuler JJ, Spigos DC, Tan WS, Justin J. An experimental evaluation of arteriography and imaging ultrasonography in detecting arterial defects at operation. J Surg Res 1982; 32: 130–137.PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1988

Authors and Affiliations

  • James Likungu
    • 1
  • H. Murdy
    • 2
  • G. Quade
    • 3
  • P. Kirchhoff
    • 1
  1. 1.Department of Cardiovascular SurgeryUniversity of Bonn Medical CenterFRG
  2. 2.Department of AnaesthesiologyUniversity of Bonn Medical CenterFRG
  3. 3.Institute of Medical Statistics, Documentation and Data ProcessingUniversity of Bonn Medical CenterFRG

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