New device for intraoperative graft assessment: HyperEye charge-coupled device camera system.
OBJECTIVE
Our institution developed a new color chargecoupled device (CCD) camera system (HyperEye system) for intraoperative indocyanine green (ICG) angiography. The device consists of a combination of custommade optical filters and an ultra-high-sensitive CCD image sensor with non-Bayer color filter array (i.e., HyperEye technology), which can detect simultaneously color and near-infrared (NIR) rays from 380 to 1200 nm. Here, we demonstrate intraoperative graft assessment using the HyperEye system.


METHODS
We investigated the intraoperative graft patency using both the HyperEye system and transittime flowmetry (TFM) in 51 patients between April 2007 and April 2009 while ICG dye was injected through a central venous catheter. Each patient signed a consent form before the surgery.


RESULTS
We obtained intraoperative graft flows and images in 189 anastomoses of 153 grafts. Both the HyperEye system and TFM indicated the patency of the grafts in 129 grafts. Both the HyperEye system and TFM detected the abnormality of the graft in seven grafts. For the competitive flows, the HyperEye system captured to-and-fro flow fluorescence and TFM detected the retrograde waveform in 16 grafts. On the other hand, although TFM indicated the patency of the graft, the HyperEye system suspected nonoccluded graft failure in seven grafts. In contrast, although TFM detected a mean flow of <10 ml/min, the HyperEye system captured the patent perfusion fluorescence in four grafts.


CONCLUSIONS
The HyperEye system can visualize any structural and functional failures. Our findings suggest that this device could become a useful tool for intraoperative graft assessment.
Department of Surgery 2, Kochi Medical School, Nankoku, Kochi, 783-8505, Japan. takemi@mpd.biglobe.ne.jp
Takemi
T
Handa
Rajesh G
RG
Katare
Hideaki
H
Nishimori
Seiichiro
S
Wariishi
Takashi
T
Fukutomi
Masaki
M
Yamamoto
Shiro
S
Sasaguri
Takayuki
T
Sato
D000368:Aged; D001783:Blood Flow Velocity; D002405:Catheterization, Central Venous; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000503:physiopathology / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D005451:Fluorescein Angiography / Q000295:instrumentation*; D005456:Fluorescent Dyes / Q000008:administration & dosage; D006083:Graft Occlusion, Vascular / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007208:Indocyanine Green / Q000008:administration & dosage; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation* / Q000379:methods; D055096:Optical Devices; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D014654:Vascular Patency
D005456:Fluorescent Dyes; D007208:Indocyanine Green