Beating heart cardioscopy: a platform for real-time, intracardiac imaging.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.
Mihaljevic
Tomislav
T
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio 44195, USA. mihaljt@ccf.org
Ootaki
Yoshio
Y
Robertson
Jason O
JO
Durrani
Amir K
AK
Kamohara
Keiji
K
Akiyama
Masatoshi
M
Cingoz
Faruk
F
Ootaki
Chiyo
C
Dessoffy
Raymond
R
Kopcak
Michael
M
Liu
Jenny
J
Fukamachi
Kiyotaka
K
D000818:Animals; D006348:Cardiac Surgical Procedures / Q000379:methods*; D019723:Endoscopes; D004724:Endoscopy; D004867:Equipment Design; D005336:Fiber Optic Technology; D006331:Heart Diseases / Q000601:surgery*; D013552:Swine