Intraoperative indocyanine green imaging as an adjunctive technique to reduce any circumflex artery damage during...

Area of Science:

• Cardiovascular Surgery
• Medical Imaging

Background:

• Iatrogenic injuries to the circumflex coronary artery during mitral valve surgery are a recognized but potentially underestimated complication.
• The artery's anatomical proximity to the mitral annulus, especially the anterolateral commissure, increases surgical risk.

Purpose of the Study:

• To assess the risk of circumflex coronary artery injury in patients undergoing mitral valve surgery.
• To evaluate the utility of indocyanine green-based fluorescence imaging in minimizing this iatrogenic risk.

Main Methods:

• A minimally invasive surgical approach was employed.
• Intraoperative fluorescence imaging using indocyanine green was utilized for real-time visualization of the circumflex coronary artery.
• The technique integrated preoperative assessments with intraoperative imaging in 6 patients.

Main Results:

• Fluorescence imaging enabled precise visualization of the circumflex artery, facilitating accurate annular suture placement.
• The technique successfully prevented iatrogenic damage to the circumflex coronary artery in all patients studied.
• The method proved effective in identifying potential vessel anomalies.

Conclusions:

• Intraoperative fluorescence imaging is a safe and effective tool for preventing iatrogenic circumflex coronary artery injury during minimally invasive mitral valve surgery.
• This technique offers significant advantages in complex cardiac procedures requiring precise anatomical visualization.
• Fluorescence imaging holds promise for broader applications in various cardiac surgeries.