Department of Surgery II, Kochi University, Kohasu, Oko, Nankoku, Kochi, 783-8505, Japan.
Surg Today. 2011 Nov;41(11):1467-74. doi: 10.1007/s00595-010-4553-0. Epub 2011 Oct 4.
Off-pump coronary arterial bypass grafting and new surgical apparatus and techniques have decreased the mortality rate associated with this procedure to approximately 1.5%. If we could detect problems in the constructed coronary anastomoses by an alternative imaging system to coronary angiography during surgery, decisions to revise the surgical procedure could be made without hesitation. Meanwhile, the intraoperative direct evaluation of intestinal blood flow during abdominal aortic aneurysmal surgery is required to prevent ischemic colitis, which is a devastating complication. Indocyanine green (ICG) has recently improved ophthalmic angiography and the navigation systems of oncological surgery. The fluorescence illumination of ICG with a near-infrared light is captured on camera. In coronary arterial surgery, the ICG imaging system is also becoming increasingly useful. A new ICG imaging system, the HyperEye Medical System (HEMS), provides a clear view of the blood flow and ischemic area with color visualization. Furthermore, its combination with a quantitative blood flow assessment tool such as transit time flow measurement could improve the accuracy of intraoperative examination. In this review, we evaluate the current strategies of assessing blood flow intraoperatively with an ICG imaging system in cardiovascular surgery.
非体外循环冠状动脉旁路移植术和新的外科器械和技术使该手术的死亡率降低到约 1.5%。如果我们能够在手术过程中通过冠状动脉造影的替代成像系统检测到构建的冠状动脉吻合口的问题，就可以毫不犹豫地决定修改手术程序。同时，需要在腹主动脉瘤手术过程中直接评估肠道血流，以预防缺血性结肠炎，这是一种破坏性的并发症。吲哚菁绿（ICG）最近改善了眼科血管造影和肿瘤外科的导航系统。近红外光激发的 ICG 荧光用相机捕捉。在冠状动脉手术中，ICG 成像系统也变得越来越有用。一种新的 ICG 成像系统，即 HyperEye Medical System（HEMS），通过彩色可视化提供清晰的血流和缺血区域视图。此外，它与瞬态血流测量等定量血流评估工具相结合，可能会提高术中检查的准确性。在这篇综述中，我们评估了心血管手术中使用 ICG 成像系统评估术中血流的当前策略。
