Assessment of flow velocity in a bypass graft of the gastroepiploic artery by contrast-enhanced transabdominal Doppler echocardiography: a case report.

An 81-year-old man with effort angina pectoris underwent coronary artery bypass grafting operation using the bilateral internal thoracic arteries and the right gastroepiploic artery (GEA). Angiography after operation showed that the bilateral internal thoracic arteries were patent. Abdominal angiography showed severe ostial stenosis in the celiac trunk. The GEA was not opacified by the celiac trunk but by the superior mesenteric artery, by collaterals. GEA flow could be detected from the epigastric lesion by contrast-enhanced Doppler echocardiography, and moreover, the flow velocity reserve of the graft was 2.4. This case suggests that the GEA graft can provide sufficient blood flow to the coronary artery despite ostial stenosis of the celiac trunk.