1. The Novadaq, “Spy Device” The Blackpool Experience
AJ Duncan & J Zacharias
Lancashire Cardiac Centre,
Blackpool Victoria Hospital, England.

2. The Background 1,100 cardiac cases. Increasing age and complexity
More vessels, smaller calibre
Off pump techniques
Endoscopic vein harvesting
Public disclosure

3. Where are we Our results in 2007: All cause mortality: 1.3%
Post op length of stay: Median: 6.6 days
Average EuroSCORE: 4.45
Average Parsonnet score:10.07

4. Is there any need to improve?

5. Areas of improvement Further reduce mortality Reduce morbidity
Offer the operation to a sicker subgroup
Improve long term results
Use arterial grafts
Control patient factors
Our results hinge on our graft patency

6. Graft patency check:. The visual test The feel test
The Doppler flow probe
Intra-op angiography
The Spy device

7. More than just great pictures?

8. The Blackpool experience
A week visit
Coincided with starting the Endoscopic conduit harvesting programme
4 surgeons tried it out
General feeling was positive

9. RIMA to LAD

10. The negative aspects The machine is large and cumbersome
The easy ones are easy but….
No clear objective scoring system
The time factor

11. Positive aspects The pictures are very clear
When there is a problem it is obvious
Used to confirm recanalised vessels
Used to check the quality of pedicled vascular grafts
Souvenir for patients

12. Pedicled Jejunal interposition graft

13. Why Spy ? Quality control To accurately record patency
To have confidence while training
To do off pump surgery without doubts
Adjunct to any new intervention

14. Sequential graft to OM1

15. Graft flow in a small vessel

16. Redo CABG Regraft

17. The Novodaq SPY Device Atrial fibrillation ablation
Port access valve programme
Atrial fibrillation ablation
3D TOE Machine
Audit and Public disclosure
18 week targets
Cost Improvement Programmes
The Novodaq SPY Device
Payment 4 performance
David Sharpe Symposium
Lung cancer targets
Minimally invasive CABG
Impact of EWTD
Hybrid Theatre
Catheter based valve replacement
Endoscopic Conduit harvesting

18. The Spy device can be to Coronary surgery what the TOE is to valve surgery: Once you get used to it you will wonder how you got by without!!
Thank You.