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Ann Thorac Surg 2002;74:497-501
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

Comparison of two stabilizer concepts for off-pump coronary artery bypass grafting

Christian Detter, MD*a, Tobias Deuse, MDa, Frank Christ, MDb, Dieter H. Boehm, MD, PhDa, Hermann Reichenspurner, MD, PhDa, Bruno Reichart, MDa

a Department of Cardiac Surgery, University Hospital Grosshadern, Ludwig-Maximilian-University, Munich, Germany
b Department of Anesthesiology, University Hospital Grosshadern, Ludwig-Maximilian-University, Munich, Germany

Accepted for publication April 25, 2002.

* Address reprint requests to Dr Detter, Department of Cardiovascular Surgery, University Hospital Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany
e-mail: detter{at}uke.uni-hamburg.de

Background. This study was designed to evaluate the efficacy of two different stabilizer concepts for off-pump coronary artery bypass grafting.

Methods. Between 2000 and 2001, 100 consecutive patients who underwent off-pump coronary artery bypass grafting were randomly assigned to two stabilization systems: the Medtronic Octopus 3 (n = 50) and the Genzyme Immobilizer (n = 50). During operation, two-dimensional cardiac surface motion was assessed by intravital microscopy using orthogonal polarization spectral imaging in 20 vessels at the anterior wall. Postoperative angiography of 47 vessels revealed anastomotic quality.

Results. Patient demographics were similar in both groups regarding age, sex, ejection fraction, and New York Heart Association functional class. In 7 patients the randomized Immobilizer was rejected by the surgeon for lateral or posterior wall revascularization and subsequently switched to the Octopus device. Patients received 1.8 ± 0.7 grafts in the Octopus and 1.6 ± 0.5 in the Immobilizer group (p = not significant). Two-dimensional cardiac surface motion was significantly less using the Immobilizer (109.7 ± 32.4 µm versus 423.5 ± 129.6 µm; p < 0.001). Time required for anastomosis was significantly shorter in the Immobilizer group (11.3 ± 3.5 versus 14.9 ± 2.4 minutes; p < 0.001). Postoperative angiography showed no vessel occlusions but two anastomotic stenoses in each group.

Conclusions. Both stabilizers have been shown useful for off-pump coronary artery bypass grafting. The Immobilizer system showed better epicardial immobilization of the anterior wall resulting in shorter anastomosis times. However, because the Octopus 3 handling is more flexible and allows easier access to all vessels, it is the device of choice for posterior wall revascularization in our institution.




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