Because coronary angiography is rarely available intraoperatively, other techniques have been developed to assess graft integrity at this time, most often the transit-time flow and intraopera- tive fluorescence imaging. The transit-time flow is a quanti- tative volume-flow technique that cannot define the severity of graft stenosis or discriminate between the influence of the graft conduit and the coronary arteriolar bed on the mean graft flow. Intraoperative fluorescence imaging, which is based on the fluorescent properties of indocyanine green, provides a semiquantitative assessment of graft patency with images that provide some details about the quality of coronary anastomoses.1260 Although both methods are valu- able in assessing graft patency, neither is sufficiently sensi- tive or specific to allow identification of more subtle abnor- malities.1260 It is hoped that such imaging may help to reduce the occurrence of technical errors. The hybrid suite can be used as an operating room and a catheterization laboratory. It allows the performance of an angiogram after CABG so that one can identify abnormal grafts, providing the opportunity to revise them (with PCI or surgery) before leaving the operating room. Until completion angiography becomes more routine (in a hybrid suite), cardiac surgeons must rely on reasonably accurate, albeit imperfect, methods to identify problems with a recently implanted graft. 8.1. Hybrid CABG/PCI Advances in surgical techniques and the introduction of DES have provided a platform for a hybrid revascularization strategy that combines grafting the LAD artery with the LIMA and stenting the non-LAD arteries with DES (instead of bypassing them with SVGs). 