Real‐time Visualization and Quantification of Retrograde Cardioplegia Delivery using Near Infrared Fluorescent Imaging

Rangaraj, Aravind T.; Ghanta, Ravi K.; Umakanthan, Ramanan; Soltesz, Edward G.; Laurence, George; Fox, John A.; Cohn, Lawrence H.; Bolman, R. Morton; Frangioni, John V.; Chen, Frederick Y.

doi:10.1111/j.1540-8191.2008.00767.x

Cited by 10 publications

(3 citation statements)

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“…NIR fluorescence imaging has several potential uses in cardiovascular surgery, including simple angiography, 10,11,81 cardioplegia delivery, 82,83 and numerous other procedures. [84][85][86][87][88][89][90][91][92][93][94][95][96][97] The use of hydroxyapatite-specific NIR fluorophores also permits the noninvasive identification of vascular calcifications.…”

Section: Cardiovascular and Vascular Imagingmentioning

confidence: 99%

Image-Guided Surgery Using Invisible Near-Infrared Light: Fundamentals of Clinical Translation

2010

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The field of biomedical optics has matured rapidly over the last decade and is poised to make a significant impact on patient care. In particular, wide-field (typically > 5 cm), planar, near-infrared (NIR) fluorescence imaging has the potential to revolutionize human surgery by providing real-time image guidance to surgeons for tissue that needs to be resected, such as tumors, and tissue that needs to be avoided, such as blood vessels and nerves. However, to become a clinical reality, optimized imaging systems and NIR fluorescent contrast agents will be needed. In this review, we introduce the principles of NIR fluorescence imaging, analyze existing NIR fluorescence imaging systems, and discuss the key parameters that guide contrast agent development. We also introduce the complexities surrounding clinical translation using our experience with the Fluorescence-Assisted Resection and Exploration (FLARE™) imaging system as an example. Finally, we introduce state-of-the-art optical imaging techniques that might someday improve image-guided surgery even further.

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Section: Cardiovascular and Vascular Imagingmentioning

confidence: 99%

Image-Guided Surgery Using Invisible Near-Infrared Light: Fundamentals of Clinical Translation

2010

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“…Physiopathology of right ventricle behavior following cardiac surgery is a largely debated issue and several hypotheses have been suggested: 1) myocardial hypothermia [ 7 ]; 2) cardiopulmonary bypass use [ 8 ]; 3) pericardial adhesions [ 9 ]. Pericardial opening need [ 10 ] and modality of cardioplegia delivery, retrograde cardiac protection seems to be less effective in preserving right ventricle function, [ 11 ] appear to be mainly involved.…”

Section: Introductionmentioning

confidence: 99%

The impact of pericardial approach and myocardial protection onto postoperative right ventricle function reduction

Zanobini

Loardi

Poggio

et al. 2018

J Cardiothorac Surg

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BackgroundThe reduction of RV function after cardiac surgery is a well-known phenomenon. It could persist up-to one year after the operation and often leads to an incomplete recovery at follow-up echocardiographic control. The aim of the present study is to analyze the impact of different modalities of pericardial incision (lateral versus anterior) and of myocardial protection protocols (Buckberg versus Custodiol) onto postoperative RV dynamic by relating two- and three-dimensional echocardiographic parameters in patients undergoing mitral valve repair through minimally invasive or traditional surgery approach.MethodsWe have analyzed 44 consecutive patients with severe degenerative mitral regurgitation who underwent mitral reparation with different surgical approach and cardioplegia type: Group 1 (17 pts): sternotomy with Buckberg cardioplegia protocol; Group 2 (10 pts): sternotomy with Custodiol cardioplegia; Group 3 (17 pts): mini-invasive surgery with Custodiol cardioplegia. Two-dimensional transthoracic echocardiography was performed pre- and 6 months post-surgery to evaluate RV function by tricuspid annular plane systolic excursion (TAPSE).ResultsAll patients underwent successful and uneventful. A postoperative TAPSE reduction was found in all groups. However, mini-invasive patients experienced a significant reduced variation versus traditional surgery.ConclusionsMini-invasive mitral repair, with lateral incision of pericardium, reduces postoperative TAPSE fall, while cardioplegia protocol fails to have an impact onto longitudinal RV function. In our study, the RV seems to experience a clinically irrelevant geometrical modification too, whose entity appears to be less evident in case of lateral pericardial approach. These results could strengthen the use of minimally invasive approach also to preserve RV function.

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“…Fluorescence imaging with ICG for malignant hepatic tumors has been rapidly approved since Ishizawa's report in 2009 [86]. ICG is a pigment dye that has been widely used clinically for liver function examinations since the late 1950s, [79,87] in which the molecular energy state increases to emit a higher energy radiation of NIR and accumulated region excited light exposure can be visualized by exclusive detectors [79,88]. ICG binds to plasma proteins and is removed from circulation exclusively by the liver to the bile juice; therefore, it might be trapped in the hypervascular area of the hepatobiliary system as malignant tumors.…”

Section: Recent Pdd Using Ala and Icg-based Nir Fluorescence Imagingmentioning

confidence: 99%

Recent Advances in Photodynamic Imaging and Therapy in Hepatobiliary Malignancies: Clinical and Experimental Aspects

et al. 2021

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The therapeutic and diagnostic modalities of light are well known, and derivative photodynamic reactions with photosensitizers (PSs), specific wavelengths of light exposure and the existence of tissue oxygen have been developed since the 20th century. Photodynamic therapy (PDT) is an effective local treatment for cancer-specific laser ablation in malignancies of some organs, including the bile duct. Although curability for extrahepatic cholangiocarcinoma is expected with surgery alone, patients with unresectable or remnant biliary cancer need other effective palliative therapies, including PDT. The effectiveness of PDT for cholangiocarcinoma has been reported experimentally or clinically, but it is not the standard option now due to problems with accompanied photosensitivity, limited access routes of irradiation, tumor hypoxia, etc. Novel derivative treatments such as photoimmunotherapy have not been applied in the field hepatobiliary system. Photodynamic diagnosis (PDD) has been more widely applied in the clinical diagnoses of liver malignancies or liver vascularization. At present, 5-aminolevulinic acid (ALA) and indocyanine green (ICG) dyes are mainly used as PSs in PDD, and ICG has been applied for detecting liver malignancies or vascularization. However, no ideal tools for combining both PDD and PDT for solid tumors, including hepatobiliary malignancies, have been clinically developed. To proceed with experimental and clinical trials, it is necessary to clarify the effective photosensitive drugs that are feasible for photochemical diagnosis and local treatment.

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Real‐time Visualization and Quantification of Retrograde Cardioplegia Delivery using Near Infrared Fluorescent Imaging

Cited by 10 publications

References 20 publications

Image-Guided Surgery Using Invisible Near-Infrared Light: Fundamentals of Clinical Translation

Image-Guided Surgery Using Invisible Near-Infrared Light: Fundamentals of Clinical Translation

The impact of pericardial approach and myocardial protection onto postoperative right ventricle function reduction

Recent Advances in Photodynamic Imaging and Therapy in Hepatobiliary Malignancies: Clinical and Experimental Aspects

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