Related Experiment Video
Updated: Jul 31, 2026
Intra-cardiac Side-Firing Light Catheter for Monitoring Cellular Metabolism using Transmural Absorbance Spectroscopy of Perfused Mammalian Hearts
Published on: May 12, 2019
Cardioscopy: potential applications and benefit in cardiac surgery
O Reuthebuch1, M Roth, W Skwara
1Max-Planck-Institute, Kerckhoff-Clinic, Department for Cardio-Thoracic Surgery, Bad Nauheim, Germany. oliver.reuthebuch@kerckhoff.med.uni-giessen.de
Insights
Cardioscopy enhances open-heart surgery safety and accuracy by providing clear visualization of intracardiac structures. This technique aids in various procedures, including septal resection and valve inspection, without increasing operative risk.
Area of Science:
- Cardiovascular Surgery
- Medical Imaging
- Surgical Technology
Background:
- Cardioscopy is not yet a routine procedure in most open-heart surgery units.
- Increasing use of cardioscopy suggests potential benefits in surgical safety and accuracy.
Purpose of the Study:
- To evaluate the utility and safety of cardioscopy in open-heart surgery.
- To assess cardioscopy's role in various surgical indications and its impact on procedure control and documentation.
Main Methods:
- Cardioscopy was performed on 100 patients between January 1996 and December 1997.
- Indications included septal resection, aortic valve evaluation, foreign body removal, VSD inspection, paravalvular leak identification, diagnostics, and surgical education.
- A 5 mm rigid or flexible cardioscope was inserted via the ascending aorta, aortic valve, or tricuspid valve during cardioplegic arrest.
Main Results:
- No complications occurred during cardioscopy procedures.
- Excellent visualization of intracardiac structures was achieved for septal resection, VSD inspection, and valve assessment.
- Intracardiac foreign bodies and tumors were successfully removed; paravalvular leakages were identified.
- Cardioscopy facilitated accurate assessment of surgical repairs and provided diagnostic information.
Conclusions:
- Cardioscopy is a valuable supporting technique for identifying intracardiac structures and controlling surgical procedures.
- It aids in documenting valve pathology and serves as an educational tool for surgical teams.
- The technique is easy to handle, does not increase operative risk, and may enable future minimally invasive approaches.
Objective:
Cardioscopy in open heart surgery is still not routine in most units. However, since our first report in 1996 we use this device more frequently, because we think that safety and accuracy of different surgical procedures is increased.
Methods:
Between 1/96 and 12/97 we performed cardioscopy in 100 patients. Indications (IND) for cardioscopy were as follows: IND (1) resection of hypertrophied septum (N = 15); IND (2) evaluation of aortic valve with low grade stenosis or insufficiency (N = 12); IND (3) removal of intracardiac foreign bodies/tumors (N = 13); IND (4) inspection of VSD prior and after repair (N = 8); IND (5) identification of paravalvular leakage (N = 8); IND (6) diagnostic purposes (N = 4); IND (7) education of surgeons and operating room staff (N = 40). During cardioplegic arrest the 5 mm rigid or flexible cardioscope (Storz, Tuttlingen, Germany) was inserted through ascending aorta, aortic valve or tricuspid valve depending on indication.
Results:
No complication occurred during cardioscopy. IND (1): there was an excellent view of all intracardiac structures. Thorough resection of hypertrophied septum was possible and there was no injury of adjacent structures or aortic valve. IND (2): all valves were inspected through a 1 cm aortic incision and the pathology of the valves was documented. In case of severe calcification, the valve was replaced although transvalvular gradient was less than 50 mm Hg. IND (3): intraventricular foreign bodies, such as felt pledges (N = 2), debris (N = 5), thrombi (N = 4) and tumors (N = 2) were entirely removed through the aortic valve with a special forceps. IND (4): anatomy of VSD was documented in all cases. It was possible to test accuracy of all patch-sutures. IND (5): all paravalvular leakages were identified even though there was heavy immobility of the mechanical valve. IND (6): a papillary muscle (N = 2) and a thrombus formation (N = 2) were diagnosed. IND (7): the surgeons and operating room staff could follow the entire procedure in all cases.
Conclusions:
Cardioscopy is a supporting technique to clearly identify intracardiac structures, to control several surgical procedures, to document valve pathology, and to educate surgeons and operating room staff. Handling is easy and does not increase operative risk. Some procedures will be performed with minimal invasivity in future.
Related Concept Videos
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion, evaluates...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:28Imaging Studies for Cardiovascular System V: CT
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:24Cardiac Catheterization III: Left Heart Catheterization