3 MATERIAL E MÉTODOS
5.2 Limitações da Técnica e do Estudo
As causas de não visualização da ATIE pelo Doppler podem ser anatômicas e operador-dependente. As anatômicas incluem configurações desfavoráveis da caixa torácica, na posição e diâmetro da ATIE enxertada e na mobilidade do coração (CROWLEY, 1994; EL MASRY, 2002). A sobreposição de vasos no acesso supraclavicular pode também prejudicar a visualização da ATIE.
Na avaliação quantitativa de fluxo do enxerto, o diâmetro da ATIE é considerado o mesmo na sístole e na diástole, devido à dificuldade técnica de se medir essa diferenciação.
Nosso estudo não obteve informações sobre as comorbidades, medicações que os pacientes estavam fazendo uso, bem como a anatomia coronariana prévia e contratilidade miocárdica segmentar e global, fatores que podem influenciar o fluxo da ATIE.
6 CONCLUSÃO
Conclui-se que valores maiores ou iguais aos estabelecidos para cada parâmetro (VPD/VPS ≥ 0.71, VTId ≥ 0.09m e FD ≥ 0,58) representam um provável indicador de patência do enxerto composto. Valores abaixo do estabelecido apresentam grande proporção de falsos negativos, não sendo conclusivo quanto à patência.
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