Intraoperative coronary artery dilatation with angioscopic guidance

The use of intraoperative balloon dilatation during coronary artery bypass surgery has been limited due to relatively unpredictable and potentially damaging results. The development of fiberoptic angioscopy permits safe visualization of the interior of coronary arteries and may be a valuable adjunct to intraoperative balloon dilatation. A 56-year-old male underwent four vessel coronary grafting with progressive intraoperative balloon dilatation of a second more distal stenosis of the left anterior descending coronary artery. Angioscopy was used to determine optimal balloon sizing and allowed visualization of associated intimal changes that occurred during the procedure, resulting in a successful outcome for this patient.