Catheterized Fiber-Optics Confocal Microscopy of the Beating Heart In Situ.

Abstract

The beating heart can be imaged using several modalities including magnetic resonance imaging, fluoroscopy, computed tomography, and ultrasound.1,2 These modalities yield images and image sequences at millimeter resolutions. Here, we present, for the first time, real-time microscopic imaging of the beating heart in situ acquired in a clinical setting using catheterized fiber-optics confocal microscopy (FCM). We demonstrate that catheterized FCM provides information on tissue microstructure in normal and fibrotic canine hearts in situ at micrometer resolution. The catheter-based approach is based on methods that we developed in previous work for imaging the arrested heart during open heart surgery.3 The study protocol was approved by the Institutional Animal Care and Use Committee, University of Utah, and performed according to National Institutes of Health guidelines. Mongrel dogs weighing 25 to 35 kg were anesthetized with sodium pentobarbital (30 mg/kg) and mechanically ventilated. Venous access was obtained in the right femoral vein under ultrasound guidance (9L4 Transducer, ACUSON SC2000; Siemens Medical Solutions, Malvern, PA). Under ultrasound (ACUSON AcuNav, Siemens) and fluoroscopic (syngo DynaCT, Siemens) guidance, a transseptal puncture was performed followed by …