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Sadahiko Arai
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Ann Thorac Surg 2005;80:1893-1897
© 2005 The Society of Thoracic Surgeons

New technology

Off-Pump CABG with Synchronized Arterial Flow Ensuring System

Go Watanabe, MD, PhD * , Hiroyuki Kamiya, MD, Hiroshi Nagamine, MD, Shigeyuki Tomita, MD, Yoshinao Koshida, MD, Satoshi Nishida, MD, Hiroshi Ohtake, MD, Sadahiko Arai, MD, Tamotsu Yasuda, MD

Department of General and Cardiothoracic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan

Accepted for publication December 28, 2004.

* Address correspondence to Dr Watanabe, Department of General and Cardiothoracic Surgery, 13-1 Takaramachi, Kanazawa, Ishikawa 920-9641, Japan (Email: go{at}med.kanazawa-u.ac.jp).

PURPOSE: We developed a synchronized, arterial-flow, ensuring system to perform coronary anastomoses safely without any ischemia-related event.

DESCRIPTION: Arterial blood is removed from the femoral artery. The resulting blood passes a switching valve and is pumped out to a syringe pump. This pump controller provides pulsatile arterial blood flow synchronized with the diastolic phase on an electrocardiogram. The arterial blood is perfused to the coronary artery through a fine flexible cannula during anastomosis.

EVALUATION: From February 1999, 524 consecutive patients were operated on using the synchronized arterial flow ensuring system. Mean duration for each anastomosis was 7.6 ± 3.3 minutes (range, 4 to 20 min). There were no intraoperative fatal arrhythmias, ventricular arrhythmias, or short-run or hemodynamic deterioration during anastomoses. No hospital death was observed, and postoperative myocardial infarction occurred in 2 patients (0.4%). Postoperative angiography showed a 98.1% patency rate.

CONCLUSIONS: The early clinical and angiographical results for off-pump CABG with the synchronized arterial flow ensuring system were excellent without mortality. We believe that off-pump CABG can be more safely performed using the synchronized arterial flow ensuring system based on our favorable results.




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