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ABSTRACT 54
Visualization of the Coronary Vasculature in
the O.R.
Fraser Rubens1, Marc Ruel1, Marino
Labinaz1, Mark Hynes1, Dario Del Rizzo2,
University of Ottawa Heart Institute1,
Ottawa, Ontario, Canada, University of Manitoba2, Winnipeg,
Manitoba, Canada.
Currently, there is no simple and effective method for validating
the quality of a coronary artery bypass graft in the operating
room. Here we report our initial experience with a novel technology
for visualizing the coronary vasculature on the operating table
at the time of a CABG procedure. This technique involves the acquisition
of images of the coronary vasculature during the first pass of
a bolus of a fluorescent contrast agent through the field of view.
Image acquisition entails positioning an imaging device, (Novadaq
Technologies Inc), above the heart and injecting a bolus of an
FDA approved fluorescent contrast agent into the right atrium.
The imaging device emits light at 806 nm causing the contrast
agent to fluoresce, emitting light at 830 nm, as it passes through
the coronary vessels. The images of the vasculature are captured
on a video camera, equipped with an 830 nm bandpass filter, and
saved to video tape. The passage of contrast agent through the
coronary vasculature can also be observed in real time on a video
monitor.
Subjects were recruited from patients requiring primary, non-emergent
coronary artery bypass surgery. Images of the coronary vasculature
were acquired prior to starting the bypass procedure and also
upon completion of the procedure, following weaning from bypass
pump where appropriate.
Excellent image quality was achieved permitting visualization
of coronary perfusion, nutrient perfusion and venous return over
the entire left ventricle. This technique permits the rapid (2-3
min) acquisition of high quality images of the coronary vasculature
under conditions appropriate to the assessment of graft quality
at the time of CABG surgery.
This is the first use of this novel technology in humans, proving
to be feasible and reproducible in the clinical setting and of
particular note it was simple to use intra-operatively.
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