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Beating heart coronary surgery supported by an axial blood flow pump
U Lönn1, B Peterzén, B Carnstam
1Linköping Heart Center, University Hospital, Sweden.
Insights
Coronary artery bypass graft operations using the Hemopump on a beating heart show reduced bleeding and myocardial trauma compared to cardiopulmonary bypass. This safe and feasible alternative offers potential benefits without increasing operating time.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Minimally Invasive Procedures
Background:
- Previously introduced method for on-pump beating heart coronary artery bypass graft (CABG) surgery.
- Exploration of this novel surgical approach in a clinical setting.
Purpose of the Study:
- To evaluate the safety and efficacy of Hemopump-assisted off-pump CABG.
- To compare outcomes with conventional cardiopulmonary bypass (CPB) techniques.
Main Methods:
- Prospective randomized trial of 32 patients undergoing CABG.
- Study group utilized Hemopump for circulatory support during on-pump beating heart surgery.
- Control group underwent traditional CPB with aortic cross-clamping and cardioplegic arrest.
Main Results:
- No major complications in either group; all patients discharged.
- Hemopump group showed significantly less intraoperative bleeding (312 mL vs. 582 mL) and myocardial trauma (Troponin-T: 0.23 µg/L vs. 1.17 µg/L).
- No significant difference in support time or total operating time; CPB group had more grafts (2.5 vs. 1.8).
Conclusions:
- Hemopump-assisted CABG is a safe and feasible alternative to CPB.
- Potential benefits include reduced operative bleeding and myocardial damage.
- The procedure does not prolong intraoperative support or overall operating time.
Background:
We have previously presented a method for performing coronary artery bypass graft operation on the beating heart without cardiopulmonary bypass (CPB). This method has now been explored.
Method:
Thirty-two patients were prospectively randomized. The study group was operated on using an axial blood flow pump (Hemopump; HP) as circulatory support. Operations were performed on the beating heart. The control group was operated on using CPB, aortic cross-clamping, and cardioplegic arrest.
Results:
All patients went through the procedure without major complications, and were discharged from the hospital. No statistical differences were observed between the groups for time on support (HP, 60.5 minutes; CPB, 70.5 minutes) or total operating time (HP, 178 minutes; CPB, 162 minutes). The number of grafts was greater in the CPB group (HP, 1.8; range, 1 to 3; CPB, 2.5; range, 1 to 4; p = 0.03). Statistical differences were found for intraoperative bleeding (HP mean, 312 mL; CPB mean, 582 mL; p = 0.0003) and myocardial trauma as measured by postoperative troponin-T values (HP, 0.23 microg/L; CPB, 1.17 microg/L; p = 0.004).
Conclusions:
Hemopump-supported coronary artery bypass graft operation has been shown to be a safe and feasible procedure with the potential benefits of reduced operative bleeding and myocardial damage without prolonging intraoperative support or total operating time.
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