The Octopus II stabilizing system: biochemical and neuropsychological outcomes in coronary artery bypass surgery.
BACKGROUND
The aim of this study was to determine if coronary artery bypass graft (CABG) surgery performed utilizing the Octopus II stabilizing system provides myocardial and cerebral protection comparable to traditional CABG surgery utilizing cardiopulmonary bypass (CPB).


METHODS
Elective patients requiring surgery for double or triple vessel disease were randomized to receive either conventional CABG with CPB (n = 14) or OPCAB using the Octopus II stabilizing system (n = 12), after receiving institutional approval and written consent. Exclusion criteria included previous cardiac surgery, recent myocardial infarction, and previous cerebrovascular disease. Troponin T (TnT) was measured preoperatively and at 2, 4, 6, 8, 10, 12, 24, and 72 hours after initiation of grafting. Neuropsychological assessments (10 measures) were performed in the week prior to surgery, one week, and six months after surgery.


RESULTS
Troponin T release was reduced in the OPCAB patients at all time points (repeated measures ANOVA p = 0.043), reaching significance at 8, 10 and 12 hours (p = 0.033, 0.038, 0.019). Other factors (composite clinical end point (prolonged LOS or ICU stay or 30-day mortality), infarction, and intubation time) did not show any significant differences between the two groups. The incidence of neuropsychological deficits was not different between the two groups at both seven-day and six-month follow-up assessments.


CONCLUSIONS
Decreased TnT release suggests a myocardial benefit for the OPCAB procedure. A neuropsychological benefit remains to be demonstrated.
Baker
R A
RA
Cardiac Surgical Research Group, Department of Cardiothoracic Surgery, Division of Medicine, Flinders Medical Centre, Bedford Park, South Australia 5042, Australia. Rob.Baker@flinders.edu.au
Andrew
M J
MJ
Ross
I K
IK
Knight
J L
JL
D000368:Aged; D001925:Brain Damage, Chronic / Q000209:etiology; D002315:Cardiopulmonary Bypass; D003071:Cognition; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D016896:Treatment Outcome