Right heart circulatory support facilities coronary artery bypass without cardiopulmonary bypass

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M Mathison1, E Buffolo, A D Jatene

  • 1Cardiopulmonary Research Science and Technology Institute, Dallas, Texas, USA. mnmathison@aol.com

The Annals of Thoracic Surgery
|October 4, 2000
PubMed

Insights

Right-heart support safely managed hemodynamic instability during beating heart coronary artery bypass (CAB) surgery. This technique enabled successful posterior wall revascularization in all patients without complications.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Anesthesia
  • Medical Devices

Background:

  • Posterior wall revascularization during beating heart coronary artery bypass (CAB) can lead to hemodynamic instability.
  • Previous studies indicated heart tilting affects right-heart hemodynamics.
  • Clinical evaluation of right-heart support was necessary.

Purpose of the Study:

  • To evaluate the safety and efficacy of a right-heart support system in clinical cases of beating heart CAB.
  • To assess the impact of right-heart support on hemodynamic stability during posterior wall revascularization.

Main Methods:

  • Seventeen patients undergoing beating heart CAB received right-heart support.
  • A coaxial cannula was placed via the right atrium to the main pulmonary artery.
  • Blood was withdrawn from the right atrium and returned to the pulmonary artery.

Main Results:

  • Successful elective beating heart CAB was performed in all 17 patients.
  • Right-heart support (1-3 L/min) improved hemodynamics, particularly during circumflex artery anastomosis.
  • No device-related incidents, infections, or air embolisms occurred; all patients were discharged.

Conclusions:

  • The right-heart support system demonstrated safety and efficacy in clinical CAB procedures.
  • This support system facilitated posterior wall exposure without causing hemodynamic compromise.
  • Right-heart support is a viable option for managing hemodynamics in complex CAB surgeries.
Abstract

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