Blood Flow Imaging: A New Two-Dimensional Ultrasound Modality for Enhanced Intraoperative Visualization of Blood Flow Patterns in Coronary Anastomoses

Objectives The study's objective was to evaluate a novel two-dimensional ultrasound imaging modality termed “blood flow imaging” (BFI) for intraoperative assessment of blood flow patterns in coronary anastomoses. The BFI modality extends color Doppler imaging (CDI) with information on flow direction and velocity that is not limited by angle dependency or aliasing artifacts. Methods Intraoperative ultrasound recordings of patent left internal mammary artery-left anterior descending anastomoses were acquired from an experimental porcine model (N = 9). Three independent observers randomly evaluated CDI and BFI cineloops with regard to different assessments of flow direction and velocity. Further, a selection of technical problems that might occur in clinical practice was induced in three pigs to investigate the resulting flow patterns. Results The BFI modality was found to provide an improved visual assessment of blood flow patterns in the left internal mammary artery-left anterior descending anastomosis compared with CDI. Conclusion The modality may therefore increase the certainty and efficiency of flow evaluation for intraoperative quality control in coronary surgery.