Intraoperative Coronary Artery Imaging for Planning.

Area of Science:

• Cardiovascular Surgery
• Medical Imaging
• Congenital Heart Disease

Background:

• Accurate coronary anatomy visualization is crucial for congenital heart surgery, particularly during ventriculotomy procedures.
• Epicardial adhesions in reoperative cases can significantly hinder the identification of coronary vessels.

Purpose of the Study:

• To describe the application of intraoperative fluorescence imaging for real-time coronary artery visualization in congenital heart surgery.
• To evaluate the safety and effectiveness of this technique in improving operative planning and minimizing coronary injury.

Main Methods:

• Utilized indocyanine green (ICG) fluorescence imaging.
• Administered ICG solution (0.28 mg/mL, 0.1-1.0 mL) via cardioplegia cannula into coronary arteries.
• Employed a handheld probe with near-infrared laser light for excitation and a camera for real-time fluorescence capture.

Main Results:

• The imaging probe provided precise visualization of coronary anatomy.
• Enabled identification of optimal ventriculotomy sites.
• Demonstrated the technique's ability to guide surgical planning and avoid coronary injury.

Conclusions:

• Intraoperative fluorescence imaging with ICG is a safe and effective method for characterizing coronary anatomy.
• This technique enhances procedural planning in congenital heart surgery.
• It significantly minimizes the risk of coronary injury, especially in reoperative scenarios.