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Ann Thorac Surg 2006;81:701-705
© 2006 The Society of Thoracic Surgeons

New technology

Temporary Right Heart Support With Percutaneous Jugular Access

Stefan P. Wirtz, MD a , c , * , Christoph Schmidt, MD a , c , Hugo Van Aken, MD, PhD a , c , Gerd Brodner, MD, PhD c , d , Dieter Hammel, MD, PhD c , d , Hans Heinrich Scheld, MD, PhD b , c , Elmar Berendes, MD, PhD a , c

a Department of Anesthesiology and Intensive Care, University Hospital Münster, Münster
b Department of Thoracic and Cardiovascular Surgery, University Hospital Münster, Münster
c Department of Anesthesia, Intensive Care and Pain Management, Fachklinik Hornheide, Münster
d Department of Thoracic and Cardiovascular Surgery, Zentralkrankenhaus Links der Weser, Bremen, Germany

Accepted for publication August 15, 2005.

* Address correspondence to Dr Wirtz, Department of Anesthesiology and Intensive Care, University Hospital Münster, Albert-Schweitzer-Straße 33, Münster, D-48149 Germany (Email: stw{at}uni-muenster.de).

PURPOSE: Temporary right heart bypass has shown to improve hemodynamic stability and safety in beating heart revascularization. We sought to evaluate feasibility and safety of a right ventricular assist device percutaneously implanted in the right jugular vein.

DESCRIPTION: The A-Med jugular coaxial cannula (A-Med Systems Inc, West Sacramento, CA) is designed for percutaneous implantation. Blood from the right heart is drained through the outer tube of this two-cannula device to a microcentrifugal pump and returned into the pulmonary artery through the inner tube.

EVALUATION: In 10 patients scheduled for elective coronary bypass grafting without cardiopulmonary bypass, a total of 27 coronary anastomoses were performed with right heart support. Arterial pressure was significantly higher with right heart support when the heart was dislocated to access posterior and posterolateral anastomosis sites. Implantation through the right internal jugular vein was feasible without complications in all patients and facilitated the procedure.

CONCLUSIONS: This initial study suggests safety and feasibility of temporary right heart support using percutaneous jugular access for posterior and posterolateral coronary bypass grafting.




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[Abstract] [Full Text] [PDF]


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