ABSTRACT 87

USE OF A REUSABLE STABILIZER IN OFF-PUMP BEATING HEART CORONARY ARTERY BYPASS: EXPERIENCE WITH 2500 CASES WORLDWIDE

 Steven R. Gundry, MD, Loma Linda University Medical Center, Loma Linda, CA 

Despite the many implied and/or real advantages of performing coronary artery anastomoses without the heart/lung machine, cost savings inherent in not using perfusion equipment can be substantial. However, most coronary artery stabilizers on the market are disposable; frequently the cost of these stabilizers exceeds the cost of the perfusion equipment which they are designed to replace. We and others have become convinced that a reusable system made out of metal provides equal or superior stability compared with plastic disposable systems while offering considerable cost savings in that the stabilizers can be reused from case to case. In this presentation, the authors present a worldwide experience with over 2500 beating heart cases using the Estech® stabilizer. The stabilizer consists of a multi-jointed arm which has a universal retractor attachment and single touch tightening/positioning motion to provide retraction and stabilization. A bendable footplate in several configurations is utilized depending upon anatomic location and surgeon preference. At several institutions, the combined use of the Estech® stabilizer with an inexpensive cardiac sling constructed from a vaginal pack has provided exposure and stability to all regions of the heart. Operative techniques using the Estech® stabilizer will be presented.

In conclusion, a reusable stabilizer/retractor system is commercially available which eliminates the need for disposable products in beating heart surgery resulting in ease of use and considerable cost savings over perfusion equipment or disposable stabilizers.