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Graft patency verification is increasingly recognized as an important component of coronary artery bypass grafting. Intuitively, eliminating intraoperative graft failure should reduce cardiac mortality and morbidity in the short term and improve clinical outcome in the long term. Although conventional angiography remains the gold standard technique for assessing graft patency, it is rarely available in the operating room and consequently several other less invasive approaches have been advocated. This article reviews the two currently most commonly used modalities for graft patency assessment, intraoperative fluorescence imaging and transit-time flowmetry, and discusses their value and limitations. Both techniques can reliably detect otherwise unsuspected occluded grafts and this is crucial for internal thoracic arteries because of their prognostic significance. Although neither technology can consistently identify more minor, non-occlusive abnormalities, the intraoperative fluorescence imaging technique seems to be more sensitive and less susceptible to "false positive" images.

Original publication

DOI

10.1016/j.athoracsur.2006.12.025

Type

Journal article

Journal

Ann Thorac Surg

Publication Date

06/2007

Volume

83

Pages

2251 - 2257

Keywords

Angiography, Coronary Artery Bypass, Fluorescence, Humans, Intraoperative Period, Rheology, Vascular Patency