High-frequency epicardial ultrasound: review of a multipurpose intraoperative tool for coronary surgery.

Background: In open-chest coronary artery bypass grafting (CABG), the surgeon faces several intraoperative challenges: (1) to locate the target coronary artery, (2) to select the optimal anastomotic site, and (3) to assess the quality of the graft and distal anastomosis. Endoscopically, these three diagnostic aims are particularly challenging.

Methods: We reviewed the literature on the intraoperative application of high-frequency (6.

Robot-assisted 13 MHz epicardial ultrasound for endoscopic quality assessment of coronary anastomoses.

In totally endoscopic coronary artery bypass surgery, intra-operative assessment of anastomotic quality is needed. We evaluated the endoscopic application of epicardial ultrasound to visualize the coronary anastomosis and detect a construction error. In 8 pigs (71-78kg), 16 internal mammary artery to left anterior descending coronary artery anastomoses were constructed conventionally, either correctly (n=8) or incorrectly with a suture cross-over construction error (n=8).

Ultrasound mini-transducer with malleable handle for coronary artery surgery.

Purpose: A 13 MHz epicardial ultrasound mini-transducer (15 x 9 x 6 mm) with a custom made malleable handling tool was evaluated to assess the coronary artery and anastomosis on all sides of the heart.

Description: On indication, in 8 patients undergoing coronary artery bypass surgery on the arrested heart, 8 coronary arteries as well as 27 coronary anastomoses were scanned.

Evaluation: The malleable handle was easily adjusted, and all sides of the heart were accessible for scanning with the mini-transducer.

Subtotal innominate vein occlusion after unsuccessful pacemaker implantation for resynchronization therapy.

Cardiac resynchronization therapy is increasingly used to treat patients with poor left ventricular function and asynchronous left ventricular contraction. Generally, a transvenous approach is used for implantation of pacing leads. However, coronary sinus lead implantation may be associated with various problems that may result in abandoning of the procedure.

Geometry assessment of coronary artery anastomoses with construction errors by epicardial ultrasound.

Objective: There is concern about the quality of the distal anastomosis in off-pump coronary artery bypass grafting. We investigated the impact of specific construction errors on anastomotic geometry using epicardial ultrasound.

Methods: Twelve ex vivo pressure perfused porcine and five isolated post-mortem human hearts were used to construct 35 internal mammary artery to coronary artery anastomoses, either without (n = 7) or with a standardized construction error (oversutured toe, oversutured heel, cross-over or purse string; each error, n = 7).

Endoscopic localization and assessment of coronary arteries by 13 MHz epicardial ultrasound.

Background: In totally endoscopic coronary artery bypass grafting the target coronary artery is difficult to locate and assess. We explored the capacity of a high-frequency epicardial ultrasound mini-transducer (Aloka, Tokyo, Japan) to endoscopically locate and assess the left anterior descending (LAD), third obtuse marginal (OM3), and right posterior descending (RDP) coronary arteries.

Methods: In eight pigs, the LAD, OM3, and RDP were endoscopically exposed.

Use of a dual-head coincidence camera and 18F-FDG for detection and nodal staging of non-small cell lung cancer: accuracy as determined by 2 independent observers.

Unlabelled: The accurate detection of lung carcinoma and the determination of its stage remain significant clinical problems. (18)F-FDG PET has been shown to improve detection and staging of lung cancer and to prevent unnecessary invasive procedures. Positron imaging with dual-head gamma cameras may not be as sensitive as PET, but recent studies have shown good results with these cameras.

Long-term clinical effect of hemodynamically optimized cardiac resynchronization therapy in patients with heart failure and ventricular conduction delay.

Objectives: We sought to compare the short- and long-term clinical effects of atrial synchronous pre-excitation of one (univentricular) or both ventricles (biventricular), that provide cardiac resynchronization therapy (CRT).

Background: In patients with heart failure (HF) who have a ventricular conduction delay, CRT improves systolic hemodynamic function. The clinical benefit of CRT is still being investigated.

Acute effects of cardiac resynchronization therapy on left ventricular Doppler indices in patients with congestive heart failure.

Background: Patients with heart failure frequently exhibit intraventricular conduction delays, which contribute to asynchronous contraction patterns and impaired hemodynamic performance. Cardiac resynchronization therapy (CRT) with biventricular (BV) and left ventricular (LV) pacing has been shown to improve both hemodynamic and clinical performance. This study investigated the effects of CRT on LV Doppler indices in these patients.