Stress-echocardiography in diagnosis of late aortocoronary bypasses stenosis
The aim of the research - to determine the diagnostic value of stress-echocardiography in diagnosis of late aortocoronary bypasses stenosis. Were included in the study 49 patients with symptoms of angina pectoris (functional class II-III) aged from 39 to 57, who underwent saphenous vein coronary artery bypass grafting from 5 to 8 years ago. To determine aortocoronary bypasses stenosis all patients underwent stress-echocardiography (stress-echoCG) in the protocol dobutamine/ transesophageal atrial pacing (TEAP) and follow up coronary angiography (CAG). The results of stress-echoCG from 39 patients suggest the presence of stenosis of bypassed arteries, in 10 cases - stenosis of noninvolved coronary arteries, which was confirmed during CAG. Opinion of aortocoronary bypasses stenosis was based on detection of local contractility impairment zones in vascular depended region of bypassed arteries. CAG revealed stenosis of distal junction of aortocoronary bypasses ≥ 70 % in 18 patients, from 50 to 70 % - in 14 patients. In 7 cases de novo segmental stenosis in of bypassed arteries were observed, which localized distal to junction of aortocoronary bypasses. In 4 patients zones of local contractility impairment revealed by stress-echoCG corresponds with stenosis of noninvolved circumflex arteries, in 6 patients - with left anterior descending artery. Accuracy and sensitivity of stress-echoCG in diagnosis of aortocoronary bypasses stenosis as well as noninvolved coronary arteries stenosis appeared to be 82,1 and 100 % correspondently. Stress-echoCG is a high informative method of early topical diagnosis of aortocoronary bypasses stenosis, as well as noninvolved coronary arteries stenosis. Early diagnosis of aortocoronary bypasses stenosis permit to produce low invasive endovascular intervention.