Comparison of two stabilizer concepts for off-pump coronary artery bypass grafting

TY - JOUR

T1 - Comparison of two stabilizer concepts for off-pump coronary artery bypass grafting

AU - Detter, Christian

AU - Deuse, Tobias

AU - Christ, Frank

AU - Boehm, Dieter H

AU - Reichenspurner, Hermann

AU - Reichart, Bruno

PY - 2002/8

Y1 - 2002/8

N2 - BACKGROUND: This study was designed to evaluate the efficacy of two different stabilizer concepts for off-pump coronary artery bypass grafting.METHODS: Between 2000 and 2001, 100 consecutive patients who underwent off-pump coronary artery bypass grafting were randomly assigned to two stabilization systems: the Medtronic Octopus 3 (n = 50) and the Genzyme Immobilizer (n = 50). During operation, two-dimensional cardiac surface motion was assessed by intravital microscopy using orthogonal polarization spectral imaging in 20 vessels at the anterior wall. Postoperative angiography of 47 vessels revealed anastomotic quality.RESULTS: Patient demographics were similar in both groups regarding age, sex, ejection fraction, and New York Heart Association functional class. In 7 patients the randomized Immobilizer was rejected by the surgeon for lateral or posterior wall revascularization and subsequently switched to the Octopus device. Patients received 1.8 +/- 0.7 grafts in the Octopus and 1.6 +/- 0.5 in the Immobilizer group (p = not significant). Two-dimensional cardiac surface motion was significantly less using the Immobilizer (109.7 +/- 32.4 microm versus 423.5 +/- 129.6 microm; p < 0.001). Time required for anastomosis was significantly shorter in the Immobilizer group (11.3 +/- 3.5 versus 14.9 +/- 2.4 minutes; p < 0.001). Postoperative angiography showed no vessel occlusions but two anastomotic stenoses in each group.CONCLUSIONS: Both stabilizers have been shown useful for off-pump coronary artery bypass grafting. The Immobilizer system showed better epicardial immobilization of the anterior wall resulting in shorter anastomosis times. However, because the Octopus 3 handling is more flexible and allows easier access to all vessels, it is the device of choice for posterior wall revascularization in our institution.

AB - BACKGROUND: This study was designed to evaluate the efficacy of two different stabilizer concepts for off-pump coronary artery bypass grafting.METHODS: Between 2000 and 2001, 100 consecutive patients who underwent off-pump coronary artery bypass grafting were randomly assigned to two stabilization systems: the Medtronic Octopus 3 (n = 50) and the Genzyme Immobilizer (n = 50). During operation, two-dimensional cardiac surface motion was assessed by intravital microscopy using orthogonal polarization spectral imaging in 20 vessels at the anterior wall. Postoperative angiography of 47 vessels revealed anastomotic quality.RESULTS: Patient demographics were similar in both groups regarding age, sex, ejection fraction, and New York Heart Association functional class. In 7 patients the randomized Immobilizer was rejected by the surgeon for lateral or posterior wall revascularization and subsequently switched to the Octopus device. Patients received 1.8 +/- 0.7 grafts in the Octopus and 1.6 +/- 0.5 in the Immobilizer group (p = not significant). Two-dimensional cardiac surface motion was significantly less using the Immobilizer (109.7 +/- 32.4 microm versus 423.5 +/- 129.6 microm; p < 0.001). Time required for anastomosis was significantly shorter in the Immobilizer group (11.3 +/- 3.5 versus 14.9 +/- 2.4 minutes; p < 0.001). Postoperative angiography showed no vessel occlusions but two anastomotic stenoses in each group.CONCLUSIONS: Both stabilizers have been shown useful for off-pump coronary artery bypass grafting. The Immobilizer system showed better epicardial immobilization of the anterior wall resulting in shorter anastomosis times. However, because the Octopus 3 handling is more flexible and allows easier access to all vessels, it is the device of choice for posterior wall revascularization in our institution.

KW - Aged

KW - Coronary Artery Bypass/instrumentation

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Prospective Studies

U2 - 10.1016/s0003-4975(02)03734-7

DO - 10.1016/s0003-4975(02)03734-7

M3 - SCORING: Journal article

C2 - 12173835

VL - 74

SP - 497

EP - 501

JO - ANN THORAC SURG

JF - ANN THORAC SURG

SN - 0003-4975

IS - 2

ER -