The Journal of Thoracic and Cardiovascular Surgery, Vol 91, 339-343, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Intraoperative angioscopy of saphenous vein and coronary arteries
TA Sanborn, JA Rygaard, BM Westbrook, HL Lazar, JR McCormick and AJ Roberts
During coronary artery bypass graft operations, the saphenous vein graft
and native coronary arteries in 17 patients were examined with a 1.7 mm
fiberoptic catheter to determine the feasibility of the procedure and its
potential for clinical application. Good to excellent visualization in 10
of 11 proximal and 10 of 10 distal coronary anastomoses was obtained
promptly and consistently. Good visualization of native coronary arteries
was obtained in only six of 11 vessels. Three of three coronary arteries
were visualized through the completed distal anastomosis, whereas only
three of eight vessels could be visualized directly through the arteriotomy
site before completion of the distal anastomosis. The image quality
improved with operator experience. Vessel distention by cold crystalloid
solution during catheter visualization was also important for obtaining
better images. Limitations of the current "state of the art" fiberoptic
catheters include the large size relative to the usual dimensions of the
native coronary vessels, a lack of perfusion channel, and the absence of an
angulation or guiding system. Potentially, angioscopic catheters may be
useful as an instructional aid during bypass operations or as a diagnostic
tool in monitoring arterial status after thrombolytic intervention, balloon
angioplasty, or laser therapy.
