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Ann Thorac Surg 2005;79:723-725
© 2005 The Society of Thoracic Surgeons

How to do it

A Simple Method of Triggering Balloon Counterpulsation Accurately During Off-Pump Coronary Artery Bypass Surgery

Takayuki Ono, MDa,*, Teiji Asakura, MDa, Takeki Ohashi, MDa, Nagara Ono, MDb

a Department of Cardiovascular Surgery, Heart Centre, Nagoya Tokushukai General Hospital, Aichi, Japan
b Department of Anesthesiology, Heart Centre, Nagoya Tokushukai General Hospital, Aichi, Japan

Accepted for publication November 21, 2003.

* Address reprint requests to Dr Ono, Department of Cardiovascular Surgery, Heart Centre, Nagoya Tokushukai General Hospital, 2-28-1 Kozoji, Kasugai, Aichi 487-0013, Japan;
takohno{at}hotmail.com

With increasing experience, off-pump coronary artery bypass grafting for high-risk patients can be performed safely. However, in patients who need intraaortic balloon counterpulsation support, mistriggering of intraaortic balloon counterpulsation during mobilization of the heart can induce unstable hemodynamic conditions. My colleagues and I have developed a simple method of detecting the trigger signal accurately: an epicardial pacemaker wire is placed close to the apex of the left ventricle, and 1 precordial V lead is disconnected and then linked to the epicardial pacemaker wire. This method provides an excellent detection of R-wave potentials in any position of the heart throughout an entire off-pump coronary artery bypass grafting procedure.




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[Abstract] [Full Text] [PDF]


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