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Ann Thorac Surg 1999;67:870-871
© 1999 The Society of Thoracic Surgeons

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How To Do It

Coronary artery bypass grafting on the beating heart: a simple technique for subluxating the heart

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

Accepted for publication August 21, 1998.

Address reprint requests to Dr Shennib, 1650 Cedar Ave, Room L9 121, Montreal, PQ, H3G 1A4, Canada
e-mail: mchs{at}musica.mcgill.ca

Coronary artery bypass grafting on the beating heart is becoming a widely applied procedure. It necessitates proper cardiac stabilization without impairment of hemodynamics. We describe a simple and effective technique to bring the anterolateral coronary arteries to a midline position for the purpose of performing a coronary artery bypass graft on the beating heart. A surgical glove tied to a tube is positioned underneath the left ventricle. Injection of warm saline into the glove will gradually displace the heart and rotate the lateral wall of the ventricle to a midline position. In spite of our use of mechanical stabilizers to decrease mobility of the anastomotic site, compression of the left ventricle is avoided because the water bed created by the injected glove absorbs the movement of the left ventricle and prevents its compression and any potential drop in cardiac output.

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