| Right heart assist ensures hemodynamic stability during beating heart coronary surgery on marginal arteries. An animal experimental porcine study. | |
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MedLine Citation:
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PMID: 11405490 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: In many heart centers myocardial revascularization using beating heart coronary surgery has partly replaced conventional coronary artery bypass grafting (cCABG) using cardiopulmonary bypass. However, access to the marginal arteries is problematic and hampered by space limitations, which might compromise the quality of the anastomoses and it entails a significant risk of hemodynamic instability subsequent to the manipulations of the heart. Hemodynamic impairment may be caused by dislocation of the low-pressure right atrium and ventricle. Therefore, it was hypothesized that the use of Right Heart Assist (RHA) may be able to ensure hemodynamic stability when tilting and manipulating the heart. DESIGN: In an animal experimental model RHA was implemented in order to study the hemodynamic impact of dislocating the heart in a standardized fashion. RESULTS: Dislocation of the unassisted heart to expose the first and second marginal branches caused a decline in arterial blood pressure, cardiac output and venous saturation of 38-48%. Supported by RHA this decrease was minimized to 0-17%. CONCLUSION: RHA for beating heart procedures indicates several advantages: ample time and safety while making the anastomoses at the marginal branches, less space limitations and enhanced control of hemodynamic stability compared with no RHA. This operation technique is challenging current practice and indications, and may potentially replace cCABG for the majority of patients. |
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Authors:
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P Hughes; J M Hasenkam; I K Severinsen; D A Steinbrüchel |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Scandinavian cardiovascular journal : SCJ Volume: 35 ISSN: 1401-7431 ISO Abbreviation: Scand. Cardiovasc. J. Publication Date: 2001 Mar |
Date Detail:
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Created Date: 2001-06-14 Completed Date: 2001-11-01 Revised Date: 2003-11-14 |
Medline Journal Info:
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Nlm Unique ID: 9708377 Medline TA: Scand Cardiovasc J Country: Norway |
Other Details:
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Languages: eng Pagination: 136-41 Citation Subset: IM |
Affiliation:
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Department of Cardiothoracic and Vascular Surgery, Skejby Sygehus, Aarhus University Hospital, Denmark. thoyer@post8.tele.dk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Blood Pressure Coronary Artery Bypass / instrumentation, methods* Coronary Disease / physiopathology, surgery Heart Rate Heart-Assist Devices* Models, Animal Oxygen / blood Stroke Volume Swine Veins |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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