The application of the Octopus stabilizing system for the treatment of high risk patients with coronary artery disease.
OBJECTIVE
If coronary disease is the target of a minimally invasive procedure, median sternotomy or cardiopulmonary bypass or both can be avoided. Similar to the development in other fields of surgery, minimally invasive surgical techniques are gaining increased acceptance in the field of cardiothoracic surgery. Our experience with an off pump coronary artery bypass (OPCAB) technique in a special patients group with serious risk factors for the application of cardiopulmonary bypass has been analyzed.


METHODS
Between March 1996 and January 1999, 88 patients (64 male, 24 female) with impaired left ventricular function, or other high risk factors jeopardizing the use of cardiopulmonary bypass, such as impaired renal or lung function or heavily calcified aorta, received a beating heart procedure using the Medtronic Octopus stabilizing system.


RESULTS
All patients survived the actual operation, however, two multimorbide patients died of pneumonia on postoperative day 31 and postoperative day 35.


CONCLUSIONS
Patients with single-vessel to multivessel disease and serious risk factors for cardiopulmonary bypass can be safely treated by OPCAB surgery. At our institution this technique presents the procedure of choice in this particular patients group.
Kappert
U
U
Cardiovascular Institute, University Dresden, Germany.
Gulielmos
V
V
Knaut
M
M
Cichon
R
R
Schneider
J
J
Schueler
S
S
D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000295:instrumentation* / Q000401:mortality; D003325:Coronary Care Units; D003327:Coronary Disease / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000401:mortality; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome