Intraoperative assessment of myocardial perfusion using near-infrared fluorescence and indocyanine green: A literature reviewCentral MessagePerspective

Background: Coronary artery bypass grafting (CABG) is among the most commonly performed major surgical procedures worldwide. While flow measurements help assess graft patency during surgery, there are limited tools available for surgeons to objectively evaluate myocardial perfusion after graft place...

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Main Authors: Roderick C. Peul, Rohit K. Kharbanda, MD, Stefan Koning, MD, Mo W. Kruiswijk, Floris P. Tange, Pim van den Hoven, MD, PhD, Alexander L. Vahrmeijer, MD, PhD, Robert J.M. Klautz, MD, PhD, Jaap F. Hamming, MD, PhD, Jesper Hjortnaes, MD, PhD, Joost R. van der Vorst, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:JTCVS Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666250725000513
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author Roderick C. Peul
Rohit K. Kharbanda, MD
Stefan Koning, MD
Mo W. Kruiswijk
Floris P. Tange
Pim van den Hoven, MD, PhD
Alexander L. Vahrmeijer, MD, PhD
Robert J.M. Klautz, MD, PhD
Jaap F. Hamming, MD, PhD
Jesper Hjortnaes, MD, PhD
Joost R. van der Vorst, MD, PhD
author_facet Roderick C. Peul
Rohit K. Kharbanda, MD
Stefan Koning, MD
Mo W. Kruiswijk
Floris P. Tange
Pim van den Hoven, MD, PhD
Alexander L. Vahrmeijer, MD, PhD
Robert J.M. Klautz, MD, PhD
Jaap F. Hamming, MD, PhD
Jesper Hjortnaes, MD, PhD
Joost R. van der Vorst, MD, PhD
author_sort Roderick C. Peul
collection DOAJ
description Background: Coronary artery bypass grafting (CABG) is among the most commonly performed major surgical procedures worldwide. While flow measurements help assess graft patency during surgery, there are limited tools available for surgeons to objectively evaluate myocardial perfusion after graft placement. Near-infrared fluorescence (NIRF) imaging shows promise in this area, offering real-time visualization of flow and perfusion without the need for radiation or nephrotoxic contrast agents. This review summarizes current knowledge of and developments in myocardial perfusion assessment via NIRF imaging, emphasizing the potential benefits of adding quantification to enhance this technique. Methods: PubMed was searched for articles describing the use of NIRF imaging for myocardial perfusion assessment. Articles were subsequently analyzed based on study objectives, subjects, and quantification capabilities. Limitations, future directions, and comparisons with other techniques were examined to recognize patterns and describe the chronological developments in NIRF imaging for myocardial perfusion assessment. Results: Twenty-eight articles were included, 11 of which explored quantification. Only 5 of these articles included patients. Aims and techniques varied significantly among studies. Compared to the abundance of qualitative assessments, quantified NIRF imaging in patients remains limited. Conclusions: This literature review highlights that NIRF imaging has been broadly researched qualitatively, showing promise for guiding CABG surgery through visualization of graft flow. However, the critical step of incorporating quantification to accurately assess myocardial perfusion remains insufficiently explored. To optimize decision making during CABG surgery, future studies must focus on intraoperative application of quantified NIRF imaging in cardiovascular patients.
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spelling doaj-art-09c33e72b8c047f18099dd1512fb00c12025-08-20T03:05:00ZengElsevierJTCVS Techniques2666-25072025-04-0130819310.1016/j.xjtc.2025.01.015Intraoperative assessment of myocardial perfusion using near-infrared fluorescence and indocyanine green: A literature reviewCentral MessagePerspectiveRoderick C. Peul0Rohit K. Kharbanda, MD1Stefan Koning, MD2Mo W. Kruiswijk3Floris P. Tange4Pim van den Hoven, MD, PhD5Alexander L. Vahrmeijer, MD, PhD6Robert J.M. Klautz, MD, PhD7Jaap F. Hamming, MD, PhD8Jesper Hjortnaes, MD, PhD9Joost R. van der Vorst, MD, PhD10Department of Surgery, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Surgery, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Surgery, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Surgery, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Surgery, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Surgery, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam-Zuidoost, The NetherlandsDepartment of Surgery, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands; Address for reprints: Dr Joost R. van der Vorst, MD, PhD, Department of Surgery, Leiden University Medical Center, Albinusdreef 2, Leiden 2333ZA, The Netherlands.Background: Coronary artery bypass grafting (CABG) is among the most commonly performed major surgical procedures worldwide. While flow measurements help assess graft patency during surgery, there are limited tools available for surgeons to objectively evaluate myocardial perfusion after graft placement. Near-infrared fluorescence (NIRF) imaging shows promise in this area, offering real-time visualization of flow and perfusion without the need for radiation or nephrotoxic contrast agents. This review summarizes current knowledge of and developments in myocardial perfusion assessment via NIRF imaging, emphasizing the potential benefits of adding quantification to enhance this technique. Methods: PubMed was searched for articles describing the use of NIRF imaging for myocardial perfusion assessment. Articles were subsequently analyzed based on study objectives, subjects, and quantification capabilities. Limitations, future directions, and comparisons with other techniques were examined to recognize patterns and describe the chronological developments in NIRF imaging for myocardial perfusion assessment. Results: Twenty-eight articles were included, 11 of which explored quantification. Only 5 of these articles included patients. Aims and techniques varied significantly among studies. Compared to the abundance of qualitative assessments, quantified NIRF imaging in patients remains limited. Conclusions: This literature review highlights that NIRF imaging has been broadly researched qualitatively, showing promise for guiding CABG surgery through visualization of graft flow. However, the critical step of incorporating quantification to accurately assess myocardial perfusion remains insufficiently explored. To optimize decision making during CABG surgery, future studies must focus on intraoperative application of quantified NIRF imaging in cardiovascular patients.http://www.sciencedirect.com/science/article/pii/S2666250725000513near-infrared fluorescence imagingindocyanine greenmyocardial perfusioncoronary artery bypass graftinggraft patencyquantification
spellingShingle Roderick C. Peul
Rohit K. Kharbanda, MD
Stefan Koning, MD
Mo W. Kruiswijk
Floris P. Tange
Pim van den Hoven, MD, PhD
Alexander L. Vahrmeijer, MD, PhD
Robert J.M. Klautz, MD, PhD
Jaap F. Hamming, MD, PhD
Jesper Hjortnaes, MD, PhD
Joost R. van der Vorst, MD, PhD
Intraoperative assessment of myocardial perfusion using near-infrared fluorescence and indocyanine green: A literature reviewCentral MessagePerspective
JTCVS Techniques
near-infrared fluorescence imaging
indocyanine green
myocardial perfusion
coronary artery bypass grafting
graft patency
quantification
title Intraoperative assessment of myocardial perfusion using near-infrared fluorescence and indocyanine green: A literature reviewCentral MessagePerspective
title_full Intraoperative assessment of myocardial perfusion using near-infrared fluorescence and indocyanine green: A literature reviewCentral MessagePerspective
title_fullStr Intraoperative assessment of myocardial perfusion using near-infrared fluorescence and indocyanine green: A literature reviewCentral MessagePerspective
title_full_unstemmed Intraoperative assessment of myocardial perfusion using near-infrared fluorescence and indocyanine green: A literature reviewCentral MessagePerspective
title_short Intraoperative assessment of myocardial perfusion using near-infrared fluorescence and indocyanine green: A literature reviewCentral MessagePerspective
title_sort intraoperative assessment of myocardial perfusion using near infrared fluorescence and indocyanine green a literature reviewcentral messageperspective
topic near-infrared fluorescence imaging
indocyanine green
myocardial perfusion
coronary artery bypass grafting
graft patency
quantification
url http://www.sciencedirect.com/science/article/pii/S2666250725000513
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