Assessment of the Coronary Sinus Diameter after Successful Coronary Artery Bypass Surgery: A Preliminary Echocardiographic Cardiac Perfusion Study

Document Type : Original Article


Department of Cardiology, Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran.


Background: There is a growing interest in noninvasive methods for the assessment of sufficient
coronary flow after coronary artery bypass graft surgery (CABG) by transthoracic
echocardiography (TTE).
Methods: We performed this study to evaluate the coronary sinus diameter (CSD), as a confident
marker of the coronary blood flow, by TTE among patients undergoing CABG. A total of 104
elective CABG patients with double, triple, or more coronary artery diseases were enrolled in
this cross-sectional study. Four patients were lost to follow-up because of poor
echocardiographic window or death. One day before and 7 days after CABG, all the patients
underwent TTE.
Results: The mean CSD was calculated by averaging the diameters of the middle and terminal
segments of the coronary sinus. The left ventricular ejection fraction (LVEF) was calculated
using the Simpson methods. The CSD in the middle (11.1%; P < 0.0001) and terminal (10.1%;
P < 0.0001) segments was significantly increased after CABG among all the patients.
Additionally, the diameter change was most prominent among those with triple vessel disease.
Similarly, a significant increase was observed in the mean CSD after CABG (11.3%;
P < 0.0001).
Conclusions: No significant changes were observed after CABG with respect to the LVEF in the first
postoperative week. The findings showed that the TTE-determined CSD could be a potential
surrogate for sufficient coronary perfusion and graft patency after CABG.


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