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Right heart assist for beating heart coronary artery bypass grafting

P Hughes1, J M Hasenkam, I K Severinsen

  • 1Department of Cardiothoracic and Vascular Surgery, Skejby Sygehus, Aarhus University Hospital, Aarhus, Denmark. phughes@rh.dk

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|October 30, 2003
PubMed

Insights

A right-sided circulatory assist device (RHA) effectively maintains hemodynamic stability during off-pump coronary artery bypass (OPCAB) surgery. This approach, RHA-OPCAB, offers a safe alternative to conventional coronary artery bypass grafting (cCABG), reducing complications.

Area of Science:

  • Cardiovascular Surgery
  • Medical Devices

Background:

  • Conventional coronary artery bypass surgery (cCABG) carries risks due to cardiopulmonary bypass.
  • Off-pump coronary artery bypass (OPCAB) is emerging but can cause hemodynamic instability.
  • Right ventricular kinking during OPCAB can compromise patient stability.

Purpose of the Study:

  • To evaluate the efficacy of a right-sided circulatory assist device (RHA) in maintaining hemodynamic stability during OPCAB.
  • To compare RHA-OPCAB with cCABG in terms of patient outcomes.

Main Methods:

  • A prospective study involving 50 patients undergoing RHA-OPCAB and 50 patients in a cCABG control group.
  • RHA was implemented before marginal artery access in the RHA-OPCAB group.

Main Results:

  • 98% of RHA-OPCAB patients achieved stable hemodynamics.
  • RHA-OPCAB patients showed significantly less postoperative bleeding (P<0.001).
  • Shorter ventilation times (P=0.001) and lower creatine kinase (CK) levels (P<0.001) were observed in the RHA-OPCAB group.

Conclusions:

  • RHA-OPCAB is a viable and safe alternative to cCABG.
  • The RHA-OPCAB procedure may lead to reduced postoperative bleeding, myocardial damage, and ventilation duration.
Abstract

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