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Efficacy of intraoperative HyperEye Medical System angiography for coronary artery bypass grafting

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Abstract

Purpose

When performing coronary artery bypass grafting, anastomotic insufficiency needs to be detected during surgery. We developed a novel indocyanine green angiography system, the HyperEye Medical System (HEMS), which enables color imaging of the bypass flow. This article described the accuracy of HEMS angiography for predicting graft patency.

Methods

A total of 144 grafts in 40 coronary artery bypass grafting patients were assessed by HEMS angiography, a transit time flowmeter (TTF) during surgery and fluoroscopic angiography 1 year after the operation.

Results

HEMS angiography showed normal flow in 133 grafts, but abnormal flow in 11. Fluoroscopic angiography showed that 130 of the 133 “normal” grafts were patent (negative predictive value: 97.7 %) and that nine of the 11 “abnormal” grafts were occluded (positive predictive value: 81.8 %). As a result, 134 grafts were assessed as normal and 10 as abnormal by TTF. Fluoroscopic angiography showed that 124 of these 134 grafts were patent (negative predictive value: 92.5 %), whereas two of the 10 grafts were occluded (positive predictive value: 20.0 %). For the 127 grafts with compatible results by the HEMS and TTF assessments, the positive and negative predictive values were 100 and 97.6 %, respectively.

Conclusion

HEMS angiography of a bypass graft may provide an accurate prediction of the graft patency after surgery.

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References

  1. Sakata R, Fujii Y, Kuwano H. Thoracic and cardiovascular surgery in Japan during 2009: annual report by the Japanese Association For Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2011;59:636–67.

    Article  PubMed  Google Scholar 

  2. Khan NE, De Souza A, Mister R, Flather M, Clague J, Davies S, et al. A randomized comparison of off-pump and on-pump multivessel coronary-artery bypass surgery. N Engl J Med. 2004;350:21–8.

    Article  CAS  PubMed  Google Scholar 

  3. D’Ancona G, Bartolozzi F, Bogers AJ, Pilato M, Parrinello M, Kappetein AP. Intraoperative graft patency verification in coronary artery surgery: modern diagnostic tools. J Cardiothorac Vasc Anesth. 2009;23:232–8.

    Article  PubMed  Google Scholar 

  4. Canver CC, Dame NA. Ultrasonic assessment of internal thoracic artery graft flow in the revascularized heart. Ann Thorac Surg. 1994;58:135–8.

    Article  CAS  PubMed  Google Scholar 

  5. Rubens FD, Ruel M, Fremes SE. A new and simplified method for coronary and graft imaging during CABG. Heart Surg Forum. 2002;5:141–4.

    PubMed  Google Scholar 

  6. Detter C, Russ D, Iffland A, Wipper S, Schurr MO, Reichenspurner H, et al. Near-infrared fluorescence coronary angiography: a new noninvasive technology for intraoperative graft patency control. Heart Surg Forum. 2002;5:364–9.

    PubMed  Google Scholar 

  7. McPherson DD, Hiratzka LF, Lamberth WC, Brandt B, Hunt M, Kieso RA, et al. Delineation of the extent of coronary atherosclerosis by high-frequency epicardial echocardiography. N Engl J Med. 1987;316:304–9.

    Article  CAS  PubMed  Google Scholar 

  8. Reuthebuch O, Haussler A, Genoni M, Tavakoli R, Odavic D, Kadner A, et al. Novadaq spy: intraoperative quality assessment in off-pump coronary artery bypass grafting. Chest. 2004;125:418–24.

    Article  PubMed  Google Scholar 

  9. 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 Thorac Surg. 2003;75:870–3.

    Article  PubMed  Google Scholar 

  10. Handa T, Katare RG, Sasaguri S, Sato T. Preliminary experience for the evaluation of the intraoperative graft patency with real color charge-coupled device camera system: an advanced device for simultaneous capturing of color and near-infrared images during coronary artery bypass graft. Interact Cardiovasc Thorac Surg. 2009;9:150–4.

    Article  PubMed  Google Scholar 

  11. Cherrick GR, Stein SW, Leevy CM, Davidson CS. Indocyanine green: observations on its physical properties, plasma decay, and hepatic extraction. J Clin Invest. 1960;39:592–600.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Yamamoto M, Sasaguri S, Sato T. Assessing intraoperative blood flow in cardiovascular surgery. Surg Today. 2011;41:1467–74.

    Article  PubMed  Google Scholar 

  13. Yamamoto M, Orihashi K, Nishimori H, Wariishi S, Fukutomi T, Kondo N, et al. Indocyanine green angiography for intra-operative assessment in vascular surgery. Eur J Vasc Endovasc Surg. 2012;43:426–32.

    Article  CAS  PubMed  Google Scholar 

  14. Desai ND, Miwa S, Kodama D, Koyama T, Cohen 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;132:585–94.

    Article  PubMed  Google Scholar 

  15. 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;130:315–20.

    Article  PubMed  Google Scholar 

  16. Handa T, Katare RG, Nishimori H, Wariishi S, Fukutomi T, Yamamoto M, et al. New device for intraoperative graft assessment: Hypereye charge-coupled device camera system. Gen Thorac Cardiovasc Surg. 58:68–77.

  17. Budde RP, Bakker PF, Grundeman PF, Borst C. High-frequency epicardial ultrasound: review of a multipurpose intraoperative tool for coronary surgery. Surg Endosc. 2009;23:467–76.

    Article  PubMed  Google Scholar 

  18. Detter C, Wipper S, Russ D, Iffland A, Burdorf L, Thein E, et al. Fluorescent cardiac imaging: a novel intraoperative method for quantitative assessment of myocardial perfusion during graded coronary artery stenosis. Circulation. 2007;116:1007–14.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank Clinical Engineers Tomotaka Takesima, Kazuhiro Imakubo, Yuto Sasaki and Kazuhiro Aki (Kochi university) for technical support with the manipulation of the HEMS. This work was supported by a grant from the Science and Technology Incubation Program in Advanced Regions from the Japan Science and Technology Agency.

Conflict of interest

The authors have no conflicts of interest to declare in association with this study.

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Authors and Affiliations

  1. Department of Surgery 2, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan

    Masaki Yamamoto, Kazumasa Orihashi, Hideaki Nishimori, Takemi Handa, Nobuo Kondo & Takashi Fukutomi

  2. Department of Cardiovascular Control, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan

    Takayuki Sato

Authors
  1. Masaki Yamamoto
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  2. Kazumasa Orihashi
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  3. Hideaki Nishimori
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  4. Takemi Handa
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  5. Nobuo Kondo
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  6. Takashi Fukutomi
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  7. Takayuki Sato
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Corresponding author

Correspondence to Masaki Yamamoto.

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Yamamoto, M., Orihashi, K., Nishimori, H. et al. Efficacy of intraoperative HyperEye Medical System angiography for coronary artery bypass grafting. Surg Today 45, 966–972 (2015). https://doi.org/10.1007/s00595-014-1015-0

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  • DOI: https://doi.org/10.1007/s00595-014-1015-0

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