 Surgeons consult the SPY system to check for problems during surgery. |
El Camino Hospital is one of only seven medical institutions in the United States to introduce an advancement in coronary artery bypass graft surgery that allows surgeons to see how well blood is flowing through a new graft so that they can make necessary corrections during the operation.
Without this technology, dubbed the SPY Intra-operative Imaging System, surgeons have to wait until after the surgery to determine whether grafts are successful. Unsuccessful grafts can lead to complications and repeat surgery.
Dr. Marc Pelletier, El Camino’s director of cardiac surgery, used the technology at the University of Toronto and was instrumental in bringing it to this country. Hospital officials announced the acquisition of the technology Nov. 28 and demonstrated it Dec. 5.
The SPY system uses an infrared laser to stimulate a fluorescent imaging agent that has been injected into the bloodstream. Stimulation by this laser emits a light that can outline the vessels and their attachments to the heart. The technique does not heat up heart tissue and does not pose any risk to the patient or staff in the operating room.
The injected agent lights up blood flowing through the veins and arteries in real time, and the camera captures live images of the heart. These images can be projected on a computer screen, saved and printed for medical reference.
The SPY system enables cardiac surgeons simply and efficiently to confirm proper placement of their bypass grafts and to assess visually the quality and effectiveness of those grafts while the patient is still in the operating room. Without this new technique, surgeons had to assume that all the grafts were perfect, but several reports suggest that 5-10 percent of them might have a correctable problem. These have only been identified if the patient became unstable or demonstrated signs of ongoing lack of blood flow to the heart.
Use of the SPY system may reduce the number of patients who return to the operating room for the revision of improperly functioning or misplaced grafts.
Traditionally, after bypass surgery, a doctor makes a calculated estimate about whether newly created vessels are functioning properly. The new technology eliminates guesswork.
The SPY system is the only fluorescent imaging system cleared by the U. S. Food and Drug Administration for use in coronary artery bypass graft surgery, the most common open-heart surgery in the country.
Approximately 400,000 patients undergo the procedure every year.
“I feel that this is an important advance for our patients at El Camino Hospital who are undergoing coronary bypass surgery,” said Pelletier. “Now, we can actually see how well blood is flowing through the new graft - something which is not possible without this technology - in order to make any necessary corrections during the operation.
“I’m hoping that this technology will help to prevent complications or additional surgery that previously may have resulted from bypass grafts not being technically perfect or having some other unforeseeable problem with them,” he said. “This gives us a critical and real-time ability to assess the bypass grafts during the operation.”
