|
ABSTRACT 86
CARDIAC POSITIONING USING AN APICAL SUCTION DEVICE
MAINTAINS HEMODYNAMICS DURING OFF-PUMP CORONARY BYPASS BY PRESERVING
RIGHT VENTRICULAR FUNCTION
Jerome Sepic, Jon Wee, Michael Hsin, Rita Laurence, Lawrence
Cohn, Lishan Aklog
Brigham & Womens Hospital, Boston, MA
Purpose: Cardiac positioning during off-pump coronary
bypass (OPCAB) using deep pericardial sutures (DPS) typically
results in some degree of hemodynamic compromise. We sought to
determine whether positioning using an apical suction device (Xpose,
Guidant, Inc) was hemodynamically superior to DPS.
Methods: Five pigs underwent sternotomy and instrumentation
to measure RA pressure, LV pressure and volume, and aortic pressure
and flow. These variables were recorded at baseline and during
exposure of the PDA and OM targets using DPS and Xpose.
Results: All values expressed as a percent of baseline
| |
PDA |
OM
|
| |
DPS |
Xpose™
|
DPS
|
Xpose™
|
| CO |
79%
|
89%
|
69%
|
83%
|
|
SV
|
84%
|
95%
|
81%
|
92%
|
|
SW
|
69%
|
90%
|
62%
|
82%
|
|
MAP
|
82%
|
96%
|
74%
|
92%
|
|
Peak LVP
|
84%
|
99%
|
77%
|
91%
|
|
LV EDP
|
43%
|
107%
|
51%
|
95%
|
|
RAP
|
117%
|
89%
|
117%
|
97%
|
All p-values<0.05.
Conclusions: DPS significantly impairs RV function leading
to underfilling of the LV. Xpose provides the same exposure with
minimal hemodynamic compromise.
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