Uniform safety of beating heart surgery using the octopus tissue stabilization system.
OBJECTIVE
Minimally invasive coronary artery bypass grafting (CABG) has been facilitated by the introduction of the Octopus Tissue Stabilization system (OTS). OTS improves exposure immobilizing the heart with minimal hemodynamic effects allowing multivessels off cardiopulmonary bypass (CPB) CABG. The purpose of this study was to compare the utilization and clinical outcome of the OTS in three geographically distinct centers.


METHODS
239 patients who underwent OTS-CABG at Allegheny University Hospital/Medical College of Pennsylvania, Harrisburg Hospital, and Park Nicollet Clinic/HealthSystem Minnesota were reviewed. Age, acuity of patients, and number and type of vessels bypassed were recorded. Complications, mortality, length of hospital stay, incidence of conversion to CPB and blood transfusions, and operating room costs were compared to risk matched control patients who underwent CPB CABG during the same period.


RESULTS
Results were similar in all three centers. The average age was 62.3 years. Emergent operation was necessary in 7%-10% of patients, the operations averaged 1.8 grafts/patient. Arteries bypassed were LAD, DIAG, OM, RCA, PDA, and RPLB. There were 96% of operations completed without CPB. Morbidity was low (12%). Atrial fibrillation and blood transfusion rate were decreased. Mortality was 0 compared with a predicted mortality of 1.6%. Hospital length of stay was shorter and operating room costs were 61% lower.


CONCLUSIONS
OTS provides predictable reproducible immobilization allowing the performance of single and multiple off-pump CABG to almost all coronary branches with minimal morbidity and decreased costs in a variety of patients. Similar findings from three different centers suggests that these results are easily reproducible.
Whitman
G J
GJ
Allegheny University Hospital/Medical College of Pennsylvania, Philadelphia, USA.
Hart
J C
JC
Crestanello
J A
JA
Spooner
T H
TH
D000368:Aged; D001026:Coronary Artery Bypass / Q000191:economics / Q000295:instrumentation*; D003327:Coronary Disease / Q000191:economics / Q000401:mortality / Q000601:surgery*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007103:Immobilization; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000191:economics / Q000295:instrumentation*; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D013525:Surgical Instruments; D015996:Survival Rate