Thermal-Coronary-Angiography (TCA) for intraoperative evaluation of graft patency in coronary artery bypass surgery

Despite the evolution of surgical techniques, coronary artery bypass graft surgery is complicated by early and late graft failure. While late graft failure is usually due to progression of the underlying disease, early graft failure can be caused by technical mistakes at the level of anastomoses. Thermal Coronary Angiography (TCA) has been developed to detect intraoperative graft failures. The method is based on the small temperature gradient that is produced by the inflow of blood into the graft and can be detected using an infrared scanner. TCA is a non-invasive method that requires no ionizing radiation or contrast documents. it allows to demonstrate graft patency of venous and arterial grafts and allows evaluation of perfusion after revalscularization. It is also helpful detect distal stenoses in native coronary arteries. With the development of total endoscopic coronary arery bypass graft procedures using robotic assistance endoscopic TCA may proof to be a valuable tool for quality control in an endoscopic setting. Its value in the field of pediatric cardiac surgery for congenital disease involving reimplantation of coronaries needs yet to be explored, in summary, TCA is a valuable tool for intraoperative quality control in coronary artery bypass graft procedures and helps to minimize the risk of postoperative complications following myocardial revascularization.