許 俊鋭, 高本 真一, 松村 誠, 横手 祐二, 尾本 良三

Shunei KYO, Shinichi TAKAMOTO, Makoto MATSUMURA, Yuji YOKOTE, Ryozo OMOTO

埼玉医科大学第一内科

Department of Surgery, Saitama Medical School

キーワード : 2-D Doppler, Transesophageal echo, Coronary flow, Non-invasive diagnosis

The proximal section of the coronary arteries were assessed in 16 patients by the transesophageal 2-D Doppler (TE 2-D Doppler) technique using 3.5 MHz and 5.0 MHz phased array transducer within six hours following open heart surgery. The left main coronary trunk was clearly observed in 94 percent of the patients (15 patients), and the proximal right coronary artery was visualized in 56 percent (9 patients). Color blood flow images of the left main trunk were obtained in 81 percent (13 patients), and of the proximal right coronary artery in 13 percent (2 patients). The average diastolic peak velocity in LMT was 74±36 cm/sec (35-164 cm/sec) by pulsed Doppler spectral analysis (Fast Fourier Transformation-FFT) in 10 patients with a non-ischemic heart disease. In a patient treated by Bentall's operation using Bjork-Shiley composite valve graft with direct coronary artery reattachment, the successful reconstruction of coronary arteries was confirmed by intraoperative TE 2-D Doppler. Coronary blood flow velocity was assessed in two patients by FFT spectral analysis during cardiac support with intra-aortic balloon counterpulsation (IABP), and a significant diastolic augmentation of the velocity wave forms with 31% and 40% increments of diastolic peak in the left main coronary artery was observed. In conclusion, transesophagea1 2-D Doppler can be an effective new method for non-invasive assessment of human coronary blood flow in physiological closed chest condition.