Related Experiment Video
Updated: Mar 8, 2026
Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
Noninvasive Quantification of Blood Flow in Epicardial Coronary Arteries, Coronary Artery Bypass Grafts, and
T Bruce Ferguson1, Cheng Chen, Sunghan Kim
1From the *Department of CV Sciences, East Carolina Heart Institute, Greenville, NC USA; †East Carolina Diabetes and Obesity Institute, Greenville, NC USA; Departments of ‡Bioengineering and §Physics, East Carolina University, Greenville, NC USA; ∥Department of CV Sciences-Interventional Cardiology, East Carolina Heart Institute, Greenville, NC USA; and ¶RFPi, LLC, Greenville, NC USA.
Insights
A new noninvasive optical imaging technology accurately quantifies coronary artery bypass grafting (CABG) blood flow and rheology. This breakthrough addresses a critical unmet need, improving intraoperative assessment and patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Biomedical Optics
- Medical Imaging
Background:
- Current methods for intraoperative blood flow assessment in coronary artery bypass grafting (CABG) are invasive and inaccurate.
- Less than 25% of CABG patients receive intraoperative evaluation due to technological limitations.
- There is a significant need for a simple, accurate, noninvasive method to assess blood flow and rheology at anastomotic sites.
Purpose of the Study:
- To develop and validate a novel noninvasive optical imaging technology for direct blood flow measurement in CABG.
- To address the limitations of existing technologies in quantifying flow in native coronary arteries, bypass conduits, and anastomoses.
- To provide real-time physiologic information at the anastomosis to improve surgical quality and outcomes.
Main Methods:
- An optical physics approach utilizing nonionizing broad-spectrum imaging was employed.
- Real-time temporal and spatial analyses were performed to quantify flow in conduits and tissue.
- Challenges including cardiac motion, calibration, and integrating anatomy with physiology in imaging were addressed.
Main Results:
- A patented imaging technology was successfully tested in a porcine model and clinical studies.
- The technology captured flow velocities and flows in epicardial coronary arteries, varying physiologically with the cardiac cycle and ischemia.
- Imaging data were acquired from a 30-cm distance, analyzed in real-time, and visualized as a video, encompassing proximal and distal coronaries, conduit, anastomosis, and myocardium.
Conclusions:
- The rheologic interaction at the anastomosis is a poorly understood aspect of CABG.
- This noninvasive, noncontact imaging technology provides critical physiologic data without risk.
- The technology can validate intraoperative quality and potentially enhance CABG outcomes.
Objective:
Direct flow measurement in native epicardial coronary arteries, bypass conduits, and anastomoses is severely limited by the invasiveness and inaccuracy of existing technologies. As a result, less than 25% of patients undergoing coronary artery bypass grafting (CABG) worldwide have any intraoperative evaluation performed. A simple, accurate, and noninvasive technology to directly quantify blood flow and rheology surrounding anastomotic sites is a critical unmet need in CABG.
Methods:
Existing technology limitations drove development of a different technology solution. With an optical physics approach, flow in conduits and tissue can be quantified in real time with nonionizing broad-spectrum imaging as well as temporal and spatial analyses. Cardiac motion, calibration, and combining anatomy + physiology in imaging were challenges requiring solutions.
Results:
This patented imaging technology was developed and tested in an established porcine cardiac experimental model and in clinical proof-of-concept studies. Flow velocities and flows in epicardial coronary arteries vary physiologically with the cardiac cycle and with acute ischemia, as predicted by previous studies using traditional technologies. Imaging data are captured from a 30-cm viewing distance, analyzed and displayed in real time as a video. The field of view enables capture of flow in the proximal and distal epicardial coronary, the conduit, at the anastomosis and in the distal myocardium simultaneously.
Conclusions:
Rheologic flow interaction between conduit and native coronary at the anastomosis remains the most poorly understood technical aspect of CABG. A noninvasive, noncontact, no-risk imaging technology as simple as a snapshot can provide this critical physiologic information, validate and document intraoperative quality, and improve even further CABG outcomes.
More Related Videos
06:39Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice
Published on: April 13, 2015
05:07Author Spotlight: Improved Localization and Monitoring of Coronary Flow Reserve Using Modified PLAX View in Mice
Published on: August 25, 2023
