Efficacy of intraoperative HyperEye Medical System angiography for coronary artery bypass grafting

Purpose When performing coronary artery bypass grafting, anastomotic insufficiency needs to be detected during surgery. We developed a novel indocyanine green angiography system, the HyperEye Medical System (HEMS), which enables color imaging of the bypass flow. This article described the accuracy of HEMS angiography for predicting graft patency. Methods A total of 144 grafts in 40 coronary artery bypass grafting patients were assessed by HEMS angiography, a transit time flowmeter (TTF) during surgery and fluoroscopic angiography 1 year after the operation. Results HEMS angiography showed normal flow in 133 grafts, but abnormal flow in 11. Fluoroscopic angiography showed that 130 of the 133 normal grafts were patent (negative predictive value: 97.7 %) and that nine of the 11 abnormal grafts were occluded (positive predictive value: 81.8 %). As a result, 134 grafts were assessed as normal and 10 as abnormal by TTF. Fluoroscopic angiography showed that 124 of these 134 grafts were patent (negative predictive value: 92.5 %), whereas two of the 10 grafts were occluded (positive predictive value: 20.0 %). For the 127 grafts with compatible results by the HEMS and TTF assessments, the positive and negative predictive values were 100 and 97.6 %, respectively. Conclusion HEMS angiography of a bypass graft may provide an accurate prediction of the graft patency after surgery.