Real-time multispectral imaging for intraoperative monitoring of coronary artery bypass graft patency

Abstract

Significance: Coronary artery disease is the leading cause of death worldwide, accounting for 16% of all deaths. A common treatment is coronary artery bypass grafting (CABG), though up to 12% of bypass grafts fail during surgery. Early detection of graft failure by intraoperative graft patency assessment could prevent severe complications. Aim: We aim to evaluate multispectral imaging (MSI) as a non-invasive, contrast free method for assessing graft patency during CABG surgery. Approach: MSI was conducted at video rate during three CABG surgeries and two control surgeries. Two multispectral snapshot cameras captured images in the visible and near-infrared range. Tissue oxygenation and perfusion were derived using linear spectral unmixing and spectral indices. Results: Significant increases in both oxygenation (12.22 10.24%, p < 0.001) and perfusion index (4.50 1.79, p < 0.001) were observed after CABG, with no significant changes in control surgeries (oxygenation: −0.36 2.57%, p ¼ 0.041;perfusion: 0.41 1.33, p ¼ 0.482). These findings demonstrate the ability of MSI to indicate graft patency, in which the bypass graft restores oxygen-rich blood flow.

Conclusions: MSI could offer a valuable tool for surgeons, helping to reduce the risk of graft failure and improve patient outcomes.