title: Expanded use of suction and stabilization devices in cardiothoracic surgery.
abstract: BACKGROUND
  Recent developments in beating heart instrumentation have allowed surgeons to perform multivessel off-pump coronary artery bypass surgery by overcoming the factors that impair surgical performance (limited visualization, continuous movement of the target area, and hemodynamic instability during exposure of the inferior and posterior parts of the heart). We have explored the possibility of further expanding apical and epicardial suction devices beyond their ordinary use in coronary artery surgery.
  
  
  METHODS
  A retrospective review of our cardiac surgery database was undertaken to identify the incidences in which these devices have been used in a somewhat novel manner in the field of cardiac surgery.
  
  
  RESULTS
  During this time period we identified 20 instances in which either apical or epicardial suction devices were used alone or together. The nature of the procedures included dividing pericardial adhesions (pericardiectomy, n = 2; dividing adhesions in redo-coronary surgery, n = 4), securing epicardial hemostasis (penetrating cardiac trauma, n = 2; securing hemostasis during reexploration after cardiac surgery, n = 10), and facilitating epicardial microwave ablation (n = 2). On all 20 occasions the intended procedures were undertaken uneventfully. Furthermore, the use of apical and epicardial devices greatly facilitated the operative procedures and avoided the use of cardiopulmonary bypass on all occasions.
  
  
  CONCLUSIONS
  In summary, we would like to highlight the expanding role for apical and epicardial suction devices to an area beyond coronary artery surgery in which we have found their use invaluable.
authors.affiliation: The National Heart and Lung Institute, Imperial College of Science, Technology and Medicine, England, London, United Kingdom. tathan5253@aol.com
authors.forename: Thanos
authors.initials: T
authors.lastname: Athanasiou
authors.forename: Pankaj
authors.initials: P
authors.lastname: Kumar
authors.forename: Sharif
authors.initials: S
authors.lastname: Al-Ruzzeh
authors.forename: Omer
authors.initials: O
authors.lastname: Aziz
authors.forename: Alexandros
authors.initials: A
authors.lastname: Charitou
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hart
authors.forename: Brian
authors.initials: B
authors.lastname: Glenville
authors.forename: Roberto
authors.initials: R
authors.lastname: Casula
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D017115:Catheter Ablation / Q000295:instrumentation; D001026:Coronary Artery Bypass / Q000295:instrumentation; D006335:Heart Injuries / Q000601:surgery; D006488:Hemostasis, Surgical / Q000295:instrumentation; D006801:Humans; D010492:Pericardiectomy / Q000295:instrumentation; D010496:Pericardium / Q000601:surgery; D012086:Reoperation / Q000295:instrumentation; D012189:Retrospective Studies; D013396:Suction / Q000295:instrumentation*; D019616:Thoracic Surgical Procedures / Q000295:instrumentation*; D000267:Tissue Adhesions / Q000601:surgery