Diagnostic Value Of Myocardial Contrast Echocardiography In Short-term Graft Patency After Off-pump Coronary Artery Bypass Grafting

Objective:To evaluate the effectiveness and reliability of myocardial contrast echocardiography in evaluating the patency of bridging vessels within one year after coronary artery bypass grafting.Methods:From October 2016 to October 2018,a total of 60 patients underwent CABG and myocardial contrast echocardiography(MCE)before and after operation were selected.There were 142 graft vessels,including 59 LAD grafts,35 LCX grafts and 46 RCA grafts.Thye were used to determine the patency of the graft vessels by the changes of myocardial perfusion in each segment before and after operation.The results of gold standard coronary computed tomography angiography were used as self-control.Results:1.Of the 142 grafts,33 were occlusion in the result of MCE,and 17 were occlusion in the result of CTA.The specificity was 81.6%,the sensitivity was 58.8%,the accuracy was 78.2%,the positive likelihood ratio was 3.2,and the negative likelihood ratio was 0.5.It is suggested that MCE can be used to evaluate the graft patency after coronary artery bypass grafting.2.Coronary CTA showed 1 graft occlusion in the LAD system,and MCE showed 7 grafts occlusion(including 1 actual occlusion).The sensitivity,specificity,accuracy,positive likelihood ratio and negative likelihood ratio were 100%,89.7%,91.4%,9.6 and 0 respectively.It is suggested that MCE can effectively evaluate the patency of LIMA-LAD grafts.3.The accuracy of MCE in evaluating the patency of RCA grafts was lower than that of anterior descending branch system(75%).The accuracy of evaluating the left circumflex branch vascular bridge was 71.4%.Conclusion: MCE is valuable in evaluating the patency of graft vessels within 1year after CABG wiyh high specificity and positive predictive,but its sensitivity is low.In particular,MCE is a accurate method to evaluate the patency of LIMA-LAD grafts with high sensitivity and specificity.