Fiberoptic cardioscopy under cardiopulmonary bypass: potential for cardioscopic surgery?

Attempts at cardioscopy have been hampered by the inability to see through blood. We describe a new method of intracardiac fiberscopic visualization performed in sheep using cardiopulmonary bypass, asanguineous cardioplegic arrest, and replacement of intracardiac blood with a clear fluid. Right heart endoscopic visualization was achieved in 4 sheep using a method that could allow extrapolation to a percutaneous approach. Two of these animals were weaned successfully from cardiopulmonary bypass. Venting and flushing aspects of the procedure were of primary importance. Further development of this technique may open the way to percutaneous endoscopically guided intracardiac operations in humans.