|
Lights. Camera. Action.
Advancing Cardiac Surgery
Innovative Technology Provides Critical Images During Cardiac Surgery
A new imaging system that lets doctors visually determine the quality and effectiveness of coronary artery bypass graft surgeries before they leave the operating room was used for the first time in Nebraska at Faith Regional Health Services over the last few weeks.
The new technology, called the SPY® Intra-operative Imaging System, is the first, and only fluorescent imaging system cleared by the U.S. Food and Drug Administration for use in coronary artery bypass surgery. Bypass operations are the most common open-heart surgery in the country with approximately 400,000 patients undergoing the procedure every year.
Until this technology became available, doctors were not able to confirm whether a patient’s coronary bypass surgery and been successful until after leaving the operating room. In most cases, only after the chest had been closed were doctors able to get an image of the heart and see whether blood was flowing through the newly created vessels. If a bypass had failed, and estimates are between 5 to 13%, the patient typically undergoes a corrective cardiac procedure or repeated bypass operation.
The SPY® System allows cardiac surgeons to know if the bypasses are successful before they close the patient’s chest and leave the operating room. This technology is proving to be a remarkable tool for surgeons and a safety measure for patient.
“There are multiple benefits of the SPY® System. It doesn’t add to the complexity of the procedure, and it gives documentation and verification of the quality of the graft prior to the closing of the chest,” said Dr. Alec Akbarov, a cardiothoracic surgeon at Faith Regional CardioVascular Institute. “Before the SPY® System was available, a doctor would have to rely on their intuition and an elaborate technique to measure the flow of the graft. If the flow was compromised after surgery, the patient would have to undergo an angiogram to ensure proper flow. By using SPY® the process is now great intra-operative imaging available to confirm the success of the graft.”
The system, made by Novadaq Technologies Inc., has been used successfully for several years in Asia, Europe and Canada, where Dr. Pelletier used it on a number of occasions as a cardiac surgeon at the University of Toronto.
Coronary artery bypass surgery is done when blood flow to the heart is blocked and drug therapy and stents are no longer effective treatments. The operation involves taking a portion of a blood vessel, or graft, from somewhere else in the body, and attaching it to a narrowed or blocked coronary artery in an effort to restore blood supply to the heart muscle.
In only a few minutes during surgery, the SPY® System can provide similar information as gathered during an X-ray angiogram, a procedure hailed as the gold standard for visualizing coronary artery blockages. Contrary to the SPY® System, however, an angiogram uses X-rays and a contrast dye that is injected into the heart. The procedure is typically performed after surgery, when a surgeon suspects a complication. Although it is possible to do an angiogram while the patient is still I the operating room, surgeons report it would be a time-consuming process, difficult to move the equipment around, and risks exposing everyone in the operating room to harmful X-rays.
Much like cardiologist s do in stent procedures, now cardiac surgeons can now make adjustments, if necessary, during the bypass operation, based on the real-time SPY® images. This will hopefully help patients avoid repeat surgery and decrease associated complications.
The SPY® System uses a fluorescent imaging agent that attaches to proteins in the blood and emits light when stimulated by an infrared laser. The technique does not heat up heart tissue and does not pose any risk to the staff in the operating room. The infected agent lights up blood flowing through the veins and arteries in real-time, an action that can be captured on a computer screen and saved.
Leading cardiac experts, like Dr. Akbarov, predict spending a few extra minutes during a four-hour operation will have benefits to the patient that will last for year.
Last Updated: 8/28/2006
|
