Abstract
Purpose
Our institution developed a new color chargecoupled device (CCD) camera system (HyperEye system) for intraoperative indocyanine green (ICG) angiography. The device consists of a combination of custommade optical filters and an ultra-high-sensitive CCD image sensor with non-Bayer color filter array (i.e., HyperEye technology), which can detect simultaneously color and near-infrared (NIR) rays from 380 to1200 nm. Here, we demonstrate intraoperative graft assessment using the HyperEye system.
Methods
We investigated the intraoperative graft patency using both the HyperEye system and transittime flowmetry (TFM) in 51 patients between April 2007 and April 2009 while ICG dye was injected through a central venous catheter. Each patient signed a consent form before the surgery.
Results
We obtained intraoperative graft flows and images in 189 anastomoses of 153 grafts. Both the HyperEye system and TFM indicated the patency of the grafts in 129 grafts. Both the HyperEye system and TFM detected the abnormality of the graft in seven grafts. For the competitive flows, the HyperEye system captured to-and-fro flow fluorescence and TFM detected the retrograde waveform in 16 grafts. On the other hand, although TFM indicated the patency of the graft, the HyperEye system suspected nonoccluded graft failure in seven grafts. In contrast, although TFM detected a mean flow of <10 ml/min, the HyperEye system captured the patent perfusion fluorescence in four grafts.
Conclusion
The HyperEye system can visualize any structural and functional failures. Our findings suggest that this device could become a useful tool for intraoperative graft assessment.
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References
Izzat MB, Khaw KS, Atassi W. Routine intraoperative angiography improves the early patency of coronary grafts performed on beating heart. Chest 1999;115:987–990.
Fabricius AM, Gerber W, Hanke M, Garbade J, Autschbach R, Mohr FW. Early angiographic control of perioperative ischemia after coronary artery bypass grafts. Eur J Cardiothorac Surg 2001;19:853–858.
D’Ancona G, Karamanoukian HL, Ricci M, Schmid S, Bergsland J, Salerno TA. Graft revision after transit time flow measurement in off-pump coronary artery bypass grafting. Eur J Cardiothorac Surg 2000;17:287–293.
Schmitz C, Ashraf O, Schiller W, Preusse CJ, Esmailzaden B, Likungu JA, et al. Transit time flow measurement in on-pump and off-pump coronary artery surgery. J Thorac Cardiovasc Surg 2003;126:645–650.
Hassanein W, Allbert AA, Arnrich B, Walter J, Ennker IC, Rosendahl U, et al. Intraoperative transit time flow measurement: off-pump versus on-pump coronary artery bypass. Ann Thorac Surg 2005;80:2155–2161.
Rubens FD, Ruel M, Fremes SE. A new and simplified method for coronary and graft imaging during CABG. Heart Surg Forum 2002;5:141–144.
Taggart DP, Choudhary B, Anastasiadis K, Abu-Omar Y, Balacumaraswami L Pigott DW. Preliminary experience with a novel intraoperative fluorescence imaging technique to evaluate the patency of bypass grafts in total arterial revascularization. Ann Thoc Surg 2003;75:870–873.
Reuthebuch O, Haussler A, Genoni M, Tavakoli R, Odavic D, Kadner A et al. Novadaq SPY: Intraoperative Quolity Assessmant in Off-Pump Coronary Artery Bypass Grafting. Chest 2004;125:418–424.
Balacumaraswami L, Abu-Omar Y, Anastasiadis K, Choudhary B, Pigott D, Yeong S-K, et al. Does off-pump total arterial grafting increase the incidence of intraoperative graft failure? J Thorac Cardiovasc Surg 2004;128:238–244.
Takahashi M, Ishikawa T, Higashidani K, Katoh H. SPYTM: an innovative intra-operative imaging system to evaluate graft patency during off-pump coronary artery bypass grafting. Interactive CardioVasc Thorac Surg 2004;3:479–483.
Desai ND, Miwa S, Kodama D, Cohen G, Christakis GT, Goldman BS, et al. Improving the quality of coronary artery bypass surgery with intraoperative angiography. J Am Coll Cardiol 2005;46:1521–1525.
Balacumaraswami L, Abu-Omar Y, Choudhary B, Pigott D, Taggart DP. A comparison of transit-time flowmetry and intraoperative fluorescence imaging for assessing coronary artery bypass graft patency. J Thorac Cardiovasc Surg 2005;130:315–320.
Desai ND, Miwa S, Kodama D, Koyama T, Chen G, Pelletier MP, et al. A randomized comparison of intraoperative indocyanine green angiography and transit-time flow measurement to detect technical errors in coronary bypass grafts. J Thorac Cardiovasc Surg 2006;132:585–594.
Balacumaraswami L, Taggart DP. Intraoperative imaging techniques to assess coronary artery bypass graft patency. Ann thorac Surg 2007;83:2251–2257.
Pagni S, Storey J, Ballen J, Montgomery W, Chiang, BY, Etoch S, et al. ITA versus SVG: a comparison of instantaneous pressure and flow dynamics during competitive flow. Eur J Cardiothorac Surg 1997;11:1086–1092.
Pagni S, Storey J, Ballen J, Montgomery W, Qaqish NK, Etoch S, et al. Factors affecting internal mammary artery graft survival: How is competitive flow from a patent native coronary vessel a risk factor? J Surg Res 1997;71:172–178.
Nakajima H, Kobayashi J, Funatsu T, Shimahara Y, Kawamura M, Kawamura A, Yagihara T, Kitamura S. Predictive factors for the intermediate-term patency of arterial grafts in aorta no-touch off-pump coronary revascularization. Eur J Cardiothorac Surg 2007;32:711–717.
Cerrito PB, Koenig SC, VanHimbergen DJ, Jaber SF, Ewert DL, Spence PA. Neural network pattern recognition analysis of graft flow characteristics improves intra-operative anastomotic error detection in minimally invasive CABG. Eur J Cardiothorac Surg 1999;16:88–93.
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Handa, T., Katare, R.G., Nishimori, H. et al. New device for intraoperative graft assessment: HyperEye charge-coupled device camera system. Gen Thorac Cardiovasc Surg 58, 68–77 (2010). https://doi.org/10.1007/s11748-009-0536-8
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DOI: https://doi.org/10.1007/s11748-009-0536-8