HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Yoshihiro Suematsu Toshiya Ohtsuka Kagami Miyaji Takeshi Miyairi Yutaka Kotsuka Shinichi Takamoto Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Suematsu, Y. Articles by Takamoto, S. Search for Related Content PubMed PubMed Citation Articles by Suematsu, Y. Articles by Takamoto, S.

Eur J Cardiothorac Surg 2000;18:276-281
© 2000 Elsevier Science NL

Right heart mini-pump bypass for coronary artery bypass grafting: experimental study

Department of Cardiothoracic Surgery, University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan

Received 9 March 2000; received in revised form 31 May 2000; accepted 28 June 2000.

Corresponding author. Tel: +81-3-5800-8654; fax: +81-3-5684-3989

Background: Visualization of the left circumflex arteries during off-pump coronary artery bypass grafting (CABG) causes hemodynamic disturbance. We investigated whether right heart mini-pump bypass (RHB), using a centrifugal pump, improved the safety of this procedure by studying the influences of different heart displacement positions, the Trendelenburg maneuver and RHB on hemodynamics. Method: Hemodynamic parameters in eight mongrel dogs (15.5–20 kg) were continuously monitored at a fixed heart rate of 80 beats/min through a conventional median sternotomy. The posterior descending artery (PDA) and left circumflex artery (LCX) were exposed using an Octopus tissue stabilizer. After evaluating the influence of the Trendelenburg maneuver on hemodynamics, a heparin-coated centrifugal pump without an oxygenator was introduced and the impact of different pump flow volumes was investigated during RHB. Results: LCX exposure caused significant decreases in aortic flow (to 35.1±12.8%) and arterial mean pressure (to 66.1±9.3%) compared with baseline (P<0.001). In contrast to PDA exposure, values remained significantly decreased during the Trendelenburg maneuver. On the contrary, RHB significantly improved the hemodynamic impairments caused by both heart displacement procedures, especially LCX exposure, although 100% pump flow significantly increased left atrial pressure to 131.3±19.5% (P<0.01). Conclusion: Exposure of the LCX caused severe hemodynamic deterioration, which was not fully reversed by the Trendelenburg maneuver. In contrast, RHB significantly improved hemodynamics, and therefore this technique can be beneficial for CABG of LCX in the limited cases.

Key Words: Right heart mini-pump bypass • Left circumflex artery exposure • Posterior descending artery exposure • Coronary artery bypass grafting

This article has been cited by other articles:

				S. P. Wirtz, C. Schmidt, H. Van Aken, G. Brodner, D. Hammel, H. H. Scheld, and E. Berendes Temporary Right Heart Support With Percutaneous Jugular Access Ann. Thorac. Surg., February 1, 2006; 81(2): 701 - 705. [Abstract] [Full Text] [PDF]

				Y. Suematsu, G. R. Marx, J. A. Stoll, P. E. DuPont, R. O. Cleveland, R. D. Howe, J. K. Triedman, T. Mihaljevic, B. N. Mora, B. J. Savord, et al. Three-dimensional echocardiography-guided beating-heart surgery without cardiopulmonary bypass: A feasibility study J. Thorac. Cardiovasc. Surg., October 1, 2004; 128(4): 579 - 587. [Abstract] [Full Text] [PDF]

				M. Caputo, M. Yeatman, P. Narayan, G. Marchetto, R. Ascione, B. C. Reeves, and G. D. Angelini Effect of off-pump coronary surgery with right ventricular assist device on organ function and inflammatory response: a randomized controlled trial Ann. Thorac. Surg., December 1, 2002; 74(6): 2088 - 2095. [Abstract] [Full Text] [PDF]