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Ann Thorac Surg 2008;85:1421-1424. doi:10.1016/j.athoracsur.2007.11.011
© 2008 The Society of Thoracic Surgeons
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New Technology

A New System for Right Atrial Cooling

Marinus A.J.M. Huybregts, MDa,*, Roel de Vroege, PhDa, Wim van Oeveren, PhDb

a Department of Cardiac Surgery, University Hospital "Vrije Universiteit," Amsterdam, the Netherlands
b Department of Biomaterials, University Medical Centre Groningen, Groningen, the Netherlands

Accepted for publication November 6, 2007.

* Address correspondence to Dr Huybregts, Department of Cardiothoracic Surgery, Vrije Universiteit Medisch Centrum, De Boelelaan 1117, 1007 MB Amsterdam, the Netherlands (Email: majm.huybregts{at}vumc.nl).

Purpose: Controlled hypothermia of the right atrium has been shown to reduce postoperative atrial fibrillation after on-pump coronary artery bypass grafting. A device has been developed that couples right atrial and nodal cooling with modified dual-stage venous drainage by circulating cold sterile saline through an intracavity, shape-memory balloon.

Description: The atrial cooling device was used in 41 patients undergoing elective coronary artery bypass grafting. Systemic temperatures were held at 36°C, and temperatures of atrial structures were reduced to about 19° to 20°C at 30 minutes.

Evaluation: Electrical activity was effectively suppressed during cross-clamp by controlled cooling of the right atrium. Hemodilution was reduced by right atrial isolation and collection of crystalloid cardioplegia. Cardiac electrical activity returned without sustained arrhythmias in all patients. Postoperative atrial fibrillation developed in only 3 of the 38 patients.

Conclusions: The results indicate that local atrial cooling may contribute to protection of the right atrium, subsequently reducing the incidence of transient postoperative atrial fibrillation.


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Invited Commentary

Ann. Thorac. Surg. 85: 1425-1425. [Full Text]



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L. L. Creswell
Invited Commentary
Ann. Thorac. Surg., April 1, 2008; 85(4): 1425 - 1425.
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