Making heart surgery intervention safer

A current trend in cardiac surgical practice is to work with an actively beating heart, rather than the more usual suppression of heart activity by low temperature. But carrying out surgical manipulation on a beating heart can lead to other problems if blood supply to the heart tissue itself is obstructed.

Three simultaneous techniques

The VIACORTIS project has developed three techniques which can be used side by side to give detailed information on the way the heart tissue is coping, so that the surgeon has early warning signals if it is becoming too stressed. Project coordinator Dr Algimantas Krisciukaitis of the Kaunas University of Medicine, Lithuania, explains: “The novelty of our method is that we developed quantitative criteria to measure heart damage. We can measure the electrical potential of the heart muscle, compare it at the same time with the biochemical activity of the tissue, and map its local heat pattern.” These three parameters together reveal early and small changes in the functional state of the heart tissue, and their exact location. This gives vital information to the surgeon on the extent of tissue damage and the time he has available to complete the procedure.

A Lithuanian-led project, VIACORTIS brought together the Biomedical Research Institute and the Heart Centre of Kaunas University, plus the Laser Research Centre of Vilnius University and Elinta Uab, a small company with expertise in multi-channel analysis of biological signals. The German partner was the Free University of Berlin’s Institute for Medical Physics and Laser Medicine, which developed the equipment to measure fluorescence as an indicator of biochemical activity. The German Institute also worked closely with Dr Krisciukaitis’ group in Kaunas to correlate fluorescence with electrical activity.

Development for the future

Because the VIACORTIS results introduce quantitative measurement of these indicators, they have made it possible to draw up optimum protocols for routine use of a range of surgical methods – showing clearly when urgency is great or when the heart tissue is not under excessive pressure. The project has successfully demonstrated the use of the triple-monitoring system, which is now ready for further development of the equipment, followed by testing, approval and manufacture, before surgeons can make use of the extra support it can offer. The results of this development have been published in journals and at conferences. “It was useful to be a EUREKA project because it gave us international recognition and government support for the participation of a small company, which worked hard and did great things,” states Dr Krisciukaitis.