Measurement of coronary sinus blood flow using transesophageal echocardiography to estimate the adequacy of revascularization in patients undergoing off-pump coronary artery bypass grafting

Abstract

Introduction Revascularization of coronary artery increases the blood flow in the coronary sinus (CS) too. The study aimed to measure the CS blood flow using transesophageal echocardiography (TEE) to estimate the adequacy of revascularization in patients undergoing off-pump coronary artery bypass grafting. Patients and methods After ethical committee approval, 100 patients scheduled for elective coronary artery bypass grafting were included in this study. After induction of balanced anesthesia according to institutional protocol, a 5-Hz multiplane phased-array TEE probe was inserted into patients’ esophagus, and the following parameters were calculated at pre-revascularization and post-revascularization periods: velocity time integral of CS, coronary sinus diameter, coronary sinus cross-section area, and coronary sinus blood flow (CSBF) per beat and per minute. Results Our study showed a statistically significant increase in velocity time integral in the post-revascularization period as compared with the pre-revascularization period (P<0.001). There was significant increment in mean CS diameter in the post-revascularization period as compared with the pre-revascularization period (0.79 vs.0.68 cm) (P<0.001). There was a significant increase in CSBF per minute in the post-revascularization period (363.8±80.55 ml) as compared with the pre-revascularization period (218.9±46.61 ml) (P<0.001). Conclusion TEE is a superior modality to evaluate CSBF before and after coronary artery bypass revascularization to determine the adequacy of surgical revascularization in real time during off-pump coronary artery bypass revascularization.