[Right heart support during coronary artery bypass grafting without cardiopulmonary bypass]

Exposure of lateral and inferior coronary vessels during off-pump coronary artery bypass grafting may cause significant hemodynamic compromise due to right ventricular compression when tilting the heart. Some new right ventricular assistance devices have been developed in order to avoid this problem but only a few series have been published. A preliminary experience with a right heart circulatory support system is reported.

A total of eight patients underwent off-pump coronary artery bypass grafting using a right heart support device. Technical procedure and clinical outcome are analyzed.

The right heart circulatory support device insertion and management were performed without any complication. A total of 21 distal coronary anastomoses were completed. They were located on the anterior descending artery(8), circumflex branches(6), diagonal branches(2), posterior descending artery(3) and right coronary artery(2). The right ventricular support device delivered flow at a medium rate of 2.2 L/min, providing hemodynamic stability when tilting the heart and exposing the coronary arteries.

The use of right heart support devices is a simple and low risk procedure which may facilitate surgical anastomoses on lateral and inferior epicardial vessels during off-pump coronary artery surgery.