Lognathen Balacumaraswami, FRCS Ed, FRCS (CTh), David P

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Intraoperative Imaging Techniques to Assess Coronary Artery Bypass Graft Patency Lognathen Balacumaraswami, FRCS Ed, FRCS (CTh), David P. Taggart, MD, PhD The Annals of Thoracic Surgery Volume 83, Issue 6, Pages 2251-2257 (June 2007) DOI: 10.1016/j.athoracsur.2006.12.025 Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) SPY (Novadaq Technologies, Inc, Toronto, Canada) image showing the right internal thoracic artery (RITA) graft to the left anterior descending coronary artery (LAD). A composite radial artery (RA) graft was placed from the RITA to the obtuse marginal (OM) coronary artery. Note that no fluorescence was seen in the RITA distal to the radial artery anastomosis, which was therefore reconstructed (see Fig 1B). (B) SPY image taken after revision of radial artery (RITA anastomosis seen in Fig 1A). Note fluorescence seen in the distal portion of the RITA graft and in the LAD. (Reprinted from Ann Thorac Surg, 75, Taggart DP, et al, Preliminary experience with a novel intraoperative fluorescence imaging technique to evaluate the patency of bypass grafts in total arterial revascularization, 870–3, Copyright (2003), with permission from The Society of Thoracic Surgeons.) The Annals of Thoracic Surgery 2007 83, 2251-2257DOI: (10.1016/j.athoracsur.2006.12.025) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Transit-time flowmetry (TTFM) display (Medistim AS, Oslo, Norway) showing the flow waveform in a left internal mammary artery (LIMA) graft to obtuse marginal (OM) branch of circumflex artery with a mean graft flow of 34 mL/min, pulsatility index (PI) of 1.5, and diastolic flow (DF) of 71%. The acoustic coupling index (ACI), which indicates the degree of contact, is 99%. Simultaneous electrocardiogram (ECG) and mean arterial pressure (78 mm Hg) are displayed on the auxiliary option (AUX 2). The Annals of Thoracic Surgery 2007 83, 2251-2257DOI: (10.1016/j.athoracsur.2006.12.025) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions