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Thirteen Years’ Experience of Intra-operative Graft Validation using SPY 2000 System and brand-new SPY 3000
Masao Takahashi1, Keisuke Miyajima1, Toshihiro Ishikawa2, Kazuyoshi Hatada2.
1Hiratsuka Kyosai Hospital, Hiratsuka, Japan, 2Odawara Municipal Hospital, Odawara, Japan.

OBJECTIVE: The SPY system has been developed for fluorescence graft validation during CABG. We are the first site in Asia-Oceania region to use SPY Intra-operative Imaging System since 2002. Based on the 13 years’ experience using SPY 2000 system, useful technique using brand-new SPY 3000 will be demonstrated.
METHODS: From March 2002 to November 2015, off pump CABG surgery was performed in 697 cases (147 MIDCAB, 550 OPCAB). The SPY System (SPY 2000) has been utilized routinely for intra-operative graft validation of all 2329 distal anastomoses. Since July 2015, the brand-new SPY 3000 system was introduced in our institute for further examination. It has color contrast mode as the figure.
RESULTS: Clear SPY images could be obtained in all 2329 distal anastomoses. Almost patients without cardiac failure could be awake from general anesthesia and extubated in the operation room, because the graft patency could be guaranteed visually by SPY system. Thirty anastomoses (1.3%) had to be revised intra-operatively, because of unfavorable SPY images. Post-CABG catheter angiography or MD-CT was performed in 91.4% patients except borderline chronic kidney disease. Early graft patency rate was satisfactory as 98.7%. All 30 revised grafts also revealed patent, including critical cases.
Several interesting examination using SP 3000 will be shown.
CONCLUSIONS: Intra-operative graft validation using SPY system will be golden standard for CABG surgery.

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