Coronary artery bypass grafting using a miniature right ventricular support system

Area of Science:

• Cardiovascular Surgery
• Medical Devices
• Cardiology

Background:

• Cardiopulmonary bypass (CPB) with cardioplegic myocardial preservation is the standard for coronary artery disease surgery.
• Current beating heart surgical techniques using epicardial stabilizing devices are limited to anterior vessels due to manipulation-induced hemodynamic compromise.

Purpose of the Study:

• To introduce a novel miniature extracorporeal system designed for beating heart surgery.
• To evaluate the system's potential for maintaining cardiac output during epicardial procedures without standard CPB.

Main Methods:

• Development of a miniature extracorporeal system with a coaxial atrial cannula and a miniature centrifugal pump.
• The system drains blood from the right atrium, pumps it, and reinfuses it into the pulmonary artery.
• The circuit has a low volume (approx. 30 ml) and is controlled externally.

Main Results:

• The system provides right ventricular support, facilitating epicardial surgical procedures on a beating heart.
• It allows for coronary anastomoses without the need for conventional cardiopulmonary bypass.
• The centrifugal pump delivers blood flow at rates of 1-6 L/min.

Conclusions:

• This miniature extracorporeal system represents a potential advancement for beating heart surgery.
• It may overcome limitations of current techniques by enabling revascularization of posterior and lateral vessels.
• The system could be beneficial in maintaining adequate cardiac output during complex epicardial interventions.