FEATURE ARTICLE

EQUIPMENT FOR INTRAOPERATIVE ASSESSMENT OF STERNAL COLLATERALS

MARK M. LEVINSON, MD
HUTCHINGSON HOSPITAL
HUTCHINSON, KS, USA

In an attempt to determine if the absence of sternal collaterals predisposes to sternal wound complications following IMA harvesting, I have searched for a method that would reliably and inexpensively assess chest wall collateral flow. A 5 mm endoscopic straight tip Doppler probe (as used by general surgeons during laparoscopic procedures) proved to be inadequate.

Recently, I have been very successful in detecting doppler flow signals in the intercostal arteries using a special bayonet Doppler probe supplied by Koven Technology, Inc. This is the only probe I have found that has the correct angle at the tip. The bayonet probe can be positioned correctly over the intrathoracic portion of the intercostal spaces and Doppler flow signals easily detected in the subcostal and superior epigastric vessels with this probe.

Click here to view the entire article