Coronary artery bypass grafting on the beating heart using the Octopus method

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery

Background:

• Coronary artery bypass grafting (CABG) is a standard treatment for coronary artery disease.
• Off-pump CABG aims to reduce complications associated with cardiopulmonary bypass.
• The Octopus heart stabilizer facilitates off-pump procedures by immobilizing the beating heart.

Purpose of the Study:

• To evaluate the safety and effectiveness of off-pump CABG using the Octopus heart stabilizer.
• To assess outcomes in patients with varying degrees of coronary artery disease and comorbidities.

Main Methods:

• Retrospective analysis of 31 patients undergoing off-pump CABG with the Octopus device (April 1996-October 1998).
• Patients divided into Group A (23 patients, suitable lesions) and Group B (8 patients, high-risk for cardiopulmonary bypass).
• Surgical access included median sternotomy, lateral thoracotomy, or minithoracotomy; left internal mammary artery (LIMA) grafts were utilized.

Main Results:

• Mean bypasses: 1.2 (Group A), 1.1 (Group B).
• LIMA to left anterior descending artery (LAD) performed in 30 patients.
• No wound infections or neurologic complications. Survival: 100% in Group A, 75% in Group B (one death from septic shock).

Conclusions:

• Off-pump CABG with the Octopus device is safe and effective, enabling complete revascularization with no mortality in suitable patients.
• The technique offers substantial benefits for high-risk patients unable to tolerate cardiopulmonary bypass.
• Median sternotomy is preferred for optimal graft harvesting and anastomosis without increased morbidity.