Temporary right heart support with percutaneous jugular access.
OBJECTIVE
Temporary right heart bypass has shown to improve hemodynamic stability and safety in beating heart revascularization. We sought to evaluate feasibility and safety of a right ventricular assist device percutaneously implanted in the right jugular vein.


METHODS
The A-Med jugular coaxial cannula (A-Med Systems Inc, West Sacramento, CA) is designed for percutaneous implantation. Blood from the right heart is drained through the outer tube of this two-cannula device to a microcentrifugal pump and returned into the pulmonary artery through the inner tube.


RESULTS
In 10 patients scheduled for elective coronary bypass grafting without cardiopulmonary bypass, a total of 27 coronary anastomoses were performed with right heart support. Arterial pressure was significantly higher with right heart support when the heart was dislocated to access posterior and posterolateral anastomosis sites. Implantation through the right internal jugular vein was feasible without complications in all patients and facilitated the procedure.


CONCLUSIONS
This initial study suggests safety and feasibility of temporary right heart support using percutaneous jugular access for posterior and posterolateral coronary bypass grafting.
Wirtz
Stefan P
SP
Department of Anesthesiology and Intensive Care, University Hospital Münster, Münster, Germany. stw@uni-muenster.de
Schmidt
Christoph
C
Van Aken
Hugo
H
Brodner
Gerd
G
Hammel
Dieter
D
Scheld
Hans Heinrich
HH
Berendes
Elmar
E
D000328:Adult; D000368:Aged; D005260:Female; D018610:Heart Bypass, Right / Q000379:methods*; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D007601:Jugular Veins / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D016896:Treatment Outcome