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Ann Thorac Surg 2008;85:1061-1065. doi:10.1016/j.athoracsur.2007.09.037
© 2008 The Society of Thoracic Surgeons
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Tomislav Mihaljevic
Yoshio Ootaki
Faruk Cingoz
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New Technology

Beating Heart Cardioscopy: A Platform for Real-Time, Intracardiac Imaging

Tomislav Mihaljevic, MDa,*, Yoshio Ootaki, MD, PhDa,b, Jason O. Robertson, BSa,c, Amir K. Durrani, BSa,c, Keiji Kamohara, MDb,b, Masatoshi Akiyama, MD, PhDb, Faruk Cingoz, MDb, Chiyo Ootaki, MDb, Raymond Dessoffy, AAb, Michael Kopcak, BAb, Jenny Liu, BAb, Kiyotaka Fukamachi, MD, PhDb

a Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
b Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio
c Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio

Accepted for publication September 18, 2007.

* Address correspondence Dr Mihaljevic, Cleveland Clinic, Department of Thoracic and Cardiovascular Surgery, 9500 Euclid Ave, Desk F24, Cleveland, OH 44195 (Email: mihaljt{at}ccf.org).

Purpose: The purpose of this study was to develop a method for real-time, fiberoptic, intracardiac imaging to serve as a platform for closed-chest, intracardiac surgery on the beating heart.

Description: Fiberoptic cardioscopy of the left and right heart was conducted in a porcine model. A cardiopulmonary bypass circuit maintained systemic organ perfusion and a separate circuit replaced intracardiac blood with oxygenated, modified Krebs-Henseleit perfusate.

Evaluation: Video images of structures in the left and right sides of an in vivo beating heart were obtained, including the inner surface of the left and right atria and ventricles, the mitral and aortic valves, the Thebesian veins, and the coronary sinus. Effective isolation of the heart from systemic and intracardiac blood flow and control of perfusion rates were important factors for successful image acquisition.

Conclusions: Fiberoptic cardioscopy is a novel approach that allows for visualization of the structures within a nonarrested heart on bypass. It lays the groundwork for a platform that could lead to more successful percutaneous valvular and intracardiac procedures in a stable hemodynamic environment.


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Invited Commentary
Georg Lutter
Ann. Thorac. Surg. 2008 85: 1065-1066. [Extract] [Full Text] [PDF]



This article has been cited by other articles:


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Beating heart cardioscopy: on-pump or off-pump?
Ann. Thorac. Surg., October 1, 2008; 86(4): 1401 - 1401.
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 Ann. Thorac. Surg.Home page
T. Mihaljevic
Reply.
Ann. Thorac. Surg., October 1, 2008; 86(4): 1401 - 1401.
[Full Text] [PDF]

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 Ann. Thorac. Surg.Home page
G. Lutter
Invited Commentary
Ann. Thorac. Surg., March 1, 2008; 85(3): 1065 - 1066.
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