Intraoperative epicardial coronary artery imaging: rationale, methods, and applications

Epicardial coronary imaging using high frequency (7-12 MHz) ultrasound probes could aid the surgeon performing coronary artery bypass procedures by localizing the coronary artery segments underneath epicardial fat, identifying the site of coronary stenosis to be bypassed, evaluating the integrity of distal coronary artery, assessing the efficacy of anastomosis, and detecting anastomotic complications. While an ideal coronary imaging probe is yet to be developed, early clinical experience with vascular imaging probes applied on the coronary vessels suggests that epicardial coronary artery imaging could enhance the optimum performance of coronary interventions. Fabrication of a flexible high frequency probe that could be applied not only on the arteries on the anterior surface of the heart but also on the lateral and posterior surfaces could facilitate development of newer surgical procedures as well.