Intraoperative coronary angioscopy: development of practical techniques.

Techniques and equipment for intraoperative coronary angioscopy were studied in the coronary arteries and cardiac veins of excised and in vivo animal hearts. These studies then allowed development of safe, practical techniques for human clinical use. In coronary artery bypass operations, multichannel angioscopes of 2.3 to 2.8 mm diameter gave the best results for examinations of the bypass vein and anastomosis, whereas smaller optical fibers of 1 mm diameter were required for inspection of the native coronary artery. Abnormalities were detected in 11 of 48 (23%) coronary bypass anastomoses, and significant discrepancy in the degree of coronary artery stenosis as compared with the preoperative angiogram was revealed in 2 patients. The authors concluded that a new design of ultrafine, multichannel angioscope would be more suitable to the different requirements for inspection of both the anastomosis and the recipient artery.