title: The role of intraoperative indocyanine green fluorescence angiography in pediatric cardiac surgery.
abstract: OBJECTIVE
  In surgical reconstructions for congenital heart defects, vessel and anastomotic site patency is critical to success. Indocyanine green fluorescence angiography offers potential for a reliable and rapid method of intraoperative assessment. We sought to determine its feasibility in congenital heart surgery.
  
  
  METHODS
  Patients undergoing the following repairs were eligible for imaging: (1) coronary artery reimplantation, (2) coarctation, (3) palliative shunts, and (4) pulmonary artery reconstruction.
  
  
  RESULTS
  Adequate postoperative images were obtained in 18 of 30 (60%) patients. Image adequacy was highest for Blalock-Taussig shunts (100%), coarctation repairs (86%), coronary reimplantations (66%), lowest for the hemi-Fontan (0%), Fontan (40%), and pulmonary artery reconstructions (33%). All adequate images showed vessel or anastomotic site patency, which corresponded to the subsequent postoperative echocardiograms and cineangiograms. There were no adverse events or mortalities.
  
  
  CONCLUSIONS
  Indocyanine green fluorescence imaging may provide an additional intraoperative imaging modality. Ultimately, the surgical procedure may be assessed and revised, if necessary, prior to leaving the operating room. This potentially will reduce the need for subsequent postoperative interventions, along with their associated morbidity and mortality.
authors.affiliation: Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA. brian_kogon@emoryhealthcare.org
authors.forename: Brian
authors.initials: B
authors.lastname: Kogon
authors.forename: Janet
authors.initials: J
authors.lastname: Fernandez
authors.forename: Kirk
authors.initials: K
authors.lastname: Kanter
authors.forename: Paul
authors.initials: P
authors.lastname: Kirshbom
authors.forename: Bob
authors.initials: B
authors.lastname: Vincent
authors.forename: Kevin
authors.initials: K
authors.lastname: Maher
authors.forename: Nina
authors.initials: N
authors.lastname: Guzetta
mesh_terms: D001017:Aortic Coarctation / Q000601:surgery; D006348:Cardiac Surgical Procedures; D004396:Coloring Agents; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000601:surgery; D005240:Feasibility Studies; D018729:Fontan Procedure; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007208:Indocyanine Green; D007432:Intraoperative Period; D014654:Vascular Patency
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green