Author Spotlight: Innovative Technique for Coronary Angiography in Marginal Donors

Screening for coronary artery disease is recommended before heart procurement in marginal donors, but is often lacking. Performing a coronary angiographic ex-situ heart perfusion could be an alternative. This video provides a detailed description of this method.

Nonconventional views are needed for coronary imaging since the heart is inverted in the perfusion module. Second, the components of the module can create artifacts for inadequate imaging. And last, the toxicity of contrast agent remains questionable since it's not eliminated from the perfusion module.

Performing coronary angiography during ex-situ heart perfusion is easily reproducible and can extrude stenosis of the main coronary vessels. Coronary angiography on an insulated perfused heart is not a common procedure for an interventional cardiologist. Providing a detailed protocol of a reproducible views can help to reduce exposure to contrast agent, which can be harmful.

A better assessment of coronary artery disease will increase the allocation of marginal grafts and could therefore reduce the organ shortage.