On Tue, 10 Jun 1997, Joseph E. Zaweski wrote:
> --- Diane Shapiro wrote:
> I am looking for information on the scanning of internal mammary artery
> prior to bypass grafts: scanning protocol, scanning tips, color/Doppler
> --- end of quoted material ---
> We start at midline (sternum) at about the level of the 3rd intercostal space,
> slowly move laterally, either direction, and you should see the IMA between
> ribs at an inch or two lateral to midline. It will be a few centimeters deep
> and the flow will be caudad. We first take a Doppler waveform to assure that
> it is triphasic (enlarge the spectrum for evaluation), anything else is
> abnormal and should raise a red flag. Second, we take a B-mode image and
> measure the diameter of the artery, it is a relatively small artery (2-5 mm).
> We do a bilateral study.
> Joe Zaweski
> Dartmouth-Hitchcock Medical Center
I confer with above scanning of IMA; however, I highly recommend also
obtaining velocities in subclavian arteries, bilaterally.If these are
stenotic and then used for bypass, patient may still experience chest pain
after surgery or during exercise.