Highlighted Case Study

4x CABG was performed on a 64 year old small, thin female with tiny tortuous vessels. The procedure was performed on-pump. Intra-operative angiography was used during the coronary artery bypass surgery (CABG) to assess graft patency. The SPY® Intra-operative Imaging System was used to perform the image acquisition.

All anastomoses were performed including the LIMA to LAD, SVG to RCA and sequential SVG to OM I & II. Intra-operative imaging was performed on the distal SVG to RCA using direct irrigation method of administering the IC-Green. An image sequence was also acquired to asses both SVG proximal anastomoses for graft patency. The SPY images demonstrated good flow through the grafts and vessels, therefore the CABG procedure was concluded as successful and uneventful.

Post-operatively, the patient had significant ST-T changes in the inferior lead distribution. A second cath revealed sluggish flow in the SVG to RCA and potential spam in the LIMA to LAD. The patient was brought back to the operating room for re-exploration.

Intra-operative angiography was used to re-assess the anastomoses. SPY images demonstrated good flow through the sequential SVG to OM and the LIMA to LAD proving the LIMA was just in spasm. Image acquisition of the proximal SVG to RCA demonstrated sluggish flow. The graft was revised and patient weaned from pump.

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