# Portable Smartphone-Based Thermal Imaging for Real-Time Assessment of Coronary Artery Bypass Grafting Graft Patency and Cardioplegia Distribution: A Feasibility Case Series

## TL;DR

A smartphone-based thermal camera was used to assess heart surgery outcomes in real-time, showing promise for low-resource settings.

## Contribution

Portable smartphone-based thermal imaging is introduced as a feasible tool for intraoperative CABG assessment in resource-limited settings.

## Key findings

- Thermal imaging successfully documented cardioplegia distribution and graft patency in all 10 cases.
- One patient's surgical sequence was adjusted based on thermal imaging findings, improving myocardial protection.
- All patients had stable postoperative outcomes with no new wall motion abnormalities.

## Abstract

Intraoperative assessment of graft patency and cardioplegia distribution
during coronary artery bypass grafting (CABG) is essential for surgical
success but remains challenging in resource-limited settings. Conventional
tools such as flow measurement or intraoperative angiography are often
unavailable in public hospitals, where evaluation relies mainly on clinical
judgment.

We conducted a prospective observational case series of 10 CABG patients
operated between February and July 2025 at a public university hospital.
Myocardial temperature distribution during cardioplegia infusion and after
grafting was monitored with a portable smartphone-based thermal camera (FLIR
One Pro).

Thermal imaging documented cardioplegia distribution and graft patency in all
cases. In one patient, heterogeneous distribution in the lateral wall was
identified, leading to a change in surgical sequence and improved myocardial
protection. All patients were weaned from bypass with stable rhythm, showed
expected postoperative troponin kinetics, and had no new wall motion
abnormalities on echocardiography.

Portable thermal imaging is a feasible, safe, and inexpensive method for
real-time intraoperative evaluation of cardioplegia distribution and graft
patency in CABG. It may represent a valuable adjunct in resource-limited
environments. Larger studies are needed to confirm these findings.