Abstract 3181: Real-Time Percutaneous Infrared Endoscopic Imaging of Intracardiac Anatomy and Tissue, including the Coronary Sinus for CRT LV Lead Implantation: From Science to Clinical Use
Objective: To design and develop technology for a catheter-based device that optically images intracardiac and intravascular anatomy and tissue in real time.
Methods: Based on Mie optical scattering theory, imaging through blood using infrared (IR) light was hypothesized. The IR optical characteristics of animal blood and human blood were analyzed. IR Endoscopes were constructed of novel flexible optical fibers. Anatomical imaging including the coronary sinus was performed in multiple species including 30 dogs and 37 pigs. Imaging through human blood was projected based on animal experimental results and analysis of erythrocyte size, O2 level, WBC count and hematocrit and confirmed in an NSR clinical study. Results: Images were obtained of intracardiac anatomy including the CS os, CS branch veins, Eustachian Ridge, Fossa Ovalis and Tricuspid Valve. Tissue detail was resolved to under 100 microns. IR Endoscopy was performed in 5 humans. The CS os was visualized in <1 minute in all patients. Branch veins were imaged in 3 patients. IR Endoscopy enabled cannulation of the CS in 4 patients. The CS os in the 5th patient was not cannulated by any means attempted. In one patient, the CS was positioned in an unusual antero-posterior direction and was able to be cannulated because of IR Endoscopy.
Conclusions: The theory of imaging through blood was demonstrated in multiple animal species and confirmed in humans. Direct real-time vision of intracardiac anatomy and tissue through flowing blood is practical and can allow for valuable procedural guidance during interventions.