Comparison of the effects of indocyanine fluorescence imaging and transit-time flow measurement on early outcomes in coronary artery bypass grafting

Background: This study aims to compare the effects of measurements taken with indocyanine green fluorescence imaging (IFI) and transit-time flowmeter measurement (TTFM) methods on the surgical outcomes of coronary artery bypass grafting. Methods: Between December 2023 and May 2024, a total of 70 patients (53 males, 17 females; mean age: 64.2 +/- 9.1 years; range, 43 to 82 years) who underwent on-pump coronary artery bypass grafting via median sternotomy by the same surgical team were included in this prospective study. The control group (TTFM group, n=35) consisted of patients who had intraoperative TTFM, while the remaining patients received both TTFM and IFI measurements during surgery (TTFM+IFI group, n=35). The groups were compared in terms of first-month survival, ejection fraction preservation, intra-aortic balloon pump use, need for extracorporeal membrane oxygenation, postoperative myocardial infarction, and length of intensive care unit and hospital stay. Results: In our clinic, distal anastomoses were performed in a mean of 3.3 +/- 0.7 vessels in the TTFM group and in a mean of 3.7 +/- 0.8 vessels in the TTFM+IFI group. The total number of distal anastomoses in the TTFM group and TTFM+IFI group was 115 and 130, respectively. According to the TTFM and IFI measurements taken during the surgery, no revision was required in any of the grafts. There was no statistically significant difference between the two compared groups in terms of early survival, postoperative myocardial infarction, need for intra-aortic balloon pump, need for extracorporeal membrane oxygenation, preservation of ejection fraction, length of stay in the intensive care unit, and time to discharge (p>0.05). Conclusion: The use of IFI yields no significant effect on early-term outcomes and TTFM is solely adequate for assessing graft functionalities in coronary artery bypass grafting.