PMID: 8461507Mar 1, 1993Paper

Identifying stunned myocardium during cardiac surgery: the role of myocardial contrast echocardiography

Journal of Cardiac Surgery
S Aronson

Abstract

Differentiation of reversibly stunned myocardium from irreversibly damaged (infarcted) myocardium is critically important in patient management. Current methods for monitoring myocardial function yield only nonspecific assessments of myocardial viability. On the other hand, myocardial contrast echocardiography (MCE) can be used to evaluate the extent of myocardial perfusion as well as the efficacy of myocardial protection in patients undergoing coronary artery bypass graft (CABG). This system includes an external ultrasound unit and an internal tracer, usually gaseous microbubbles, which reflect the ultrasonic beam. Previous studies have shown that myocardial risk areas identified with MCE correlate with areas defined by technetium autoradiography and infarction size. We have used MCE to evaluate coronary artery bypass patients (N = 21) with regard to myocardial function and cardioplegia perfusion patterns. A significant correlation (p < 0.01) was found between abnormal contrast enhanced cardioplegia patterns and depression of left ventricular function. Refinements to ultrasound technology and contrast agents will further enhance the diagnostic power of MCE for the quantification of myocardial blood flow.

References

Feb 1, 1989·Journal of the American College of Cardiology·S KaulD D Watson
Jan 1, 1988·Journal of the American College of Cardiology·S B FeinsteinK M Borow
Sep 1, 1984·Journal of the American College of Cardiology·S B FeinsteinY Fujibayashi
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Dec 1, 1982·Circulation·E Braunwald, R A Kloner
Sep 1, 1991·American Journal of Cardiac Imaging·S Aronson

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Citations

Dec 1, 1993·The Annals of Thoracic Surgery·W J GreeleyR M Ungerleider
Jan 13, 2001·The Annals of Thoracic Surgery·J J AmatoF Lukash
Mar 29, 2002·American Journal of Surgery·Mauro SalizzoniFausto Zamboni

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