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Ann Thorac Surg 1997;63:988-992
© 1997 The Society of Thoracic Surgeons

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Original Article: Cardiovascular

Safe and Effective Method of Stabilization for Coronary Artery Bypass Grafting on the Beating Heart

Department of Cardiothoracic Surgery, McGill University, Montreal, Quebec, Canada

Accepted for publication October 22, 1996.

Background. There is an emerging interest in performing coronary artery bypass grafting on the beating heart. This study examines the efficacy and safety of two types of coronary artery stabilizers developed to perform coronary artery bypass grafting on the beating heart.

Methods. Four dogs underwent left internal mammary artery to left anterior descending artery anastomosis using a retractor-fixed stabilizer. Measurements of hemodynamic indices and range of motion of the targeted arteriotomy were done before and after application of the stabilizers. Patency of the anastomosis was evaluated by angiography. To clinically validate the safety of this stabilizer, we collected data on 150 patients from centers that had access to the retractor-fixed stabilizer.

Results. All animals survived the procedure with no ischemic changes or hemodynamic alterations. A significant reduction in range of motion (mm) of the left anterior descending coronary artery was achieved after application of the stabilizers. Angiographic studies showed good anastomotic patency. Histologic examination showed no myocardial injury. Patient data revealed successful completion of the anastomosis, with conversion to sternotomy or cardiopulmonary bypass in 1 patient each. Intraoperative and postoperative myocardial infarctions occurred in 1 patient each, with one in-hospital death.

Conclusions. Significant stabilization of targeted coronary arteries allowing the performance of safe and reliable anastomosis on a beating heart can be achieved using the stabilizer.

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Invited Commentary

Pascal R. Vouhé
Ann. Thorac. Surg. 1997 63: 980. [Extract] [Full Text]

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