The role of intraoperative indocyanine green fluorescence angiography in pediatric cardiac surgery.
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.
Kogon
Brian
B
Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA. brian_kogon@emoryhealthcare.org
Fernandez
Janet
J
Kanter
Kirk
K
Kirshbom
Paul
P
Vincent
Bob
B
Maher
Kevin
K
Guzetta
Nina
N
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
D004396:Coloring Agents; D007208:Indocyanine Green