title: The enabler right ventricular circulatory support system for beating heart coronary artery bypass graft surgery.
abstract: BACKGROUND
  Beating heart coronary artery bypass graft surgery of the left anterior descending, diagonal, and right coronary artery can be performed safely with the Octopus Stabilization System. However, tilting of the heart, which is necessary to reach the obtuse marginal and distal right coronary arteries, causes hemodynamic instability. This study was performed to investigate the possible role of the Enabler right ventricular circulatory support system in counteracting this instability.
  
  
  METHODS
  In 8 sheep, the Enabler cannula was introduced via the jugular vein and positioned with the inlet valve in the right atrium and outlet valve in the pulmonary artery. The Octopus was used to expose the inferior wall and the posterior wall of the left ventricle. The hemodynamic effects of this tilting with and without Enabler right ventricular support were recorded, including Pressure Volume (PV) loops measured by conductance catheters in both ventricles.
  
  
  RESULTS
  Tilting caused a reduction in stroke volume (inferior 31%, posterior 17%) and Enabler activation increased stroke volume (inferior 13%, posterior 31%).
  
  
  CONCLUSIONS
  Tilting the heart has severe hemodynamic consequences that can be partially counteracted by the use of the Enabler for right ventricle support.
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital and Cardiovascular Research Institute, Maastricht, The Netherlands. g.geskes@scpc.azm.nl
authors.forename: G G
authors.initials: GG
authors.lastname: Geskes
authors.forename: A L
authors.initials: AL
authors.lastname: Dekker
authors.forename: F H
authors.initials: FH
authors.lastname: van der Veen
authors.forename: A A
authors.initials: AA
authors.lastname: Cramers
authors.forename: J G
authors.initials: JG
authors.lastname: Maessen
authors.forename: D
authors.initials: D
authors.lastname: Shoshani
authors.forename: K B
authors.initials: KB
authors.lastname: Prenger
mesh_terms: D000818:Animals; D002404:Catheterization / Q000295:instrumentation; D001026:Coronary Artery Bypass / Q000295:instrumentation*; D004724:Endoscopy; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D006353:Heart-Assist Devices; D006439:Hemodynamics / Q000502:physiology; D013318:Stroke Volume / Q000502:physiology