The enables right ventricular circulatory support system for beating heartcoronary artery bypass graft surgery

Background. Beating heart coronary artery bypass graft surgery of the left anterior descending, diagonal, and right coronary artery can be performed s afely with the Octopus Stabilization System. However, tilting of the heart, which is necessary to reach the obtuse marginal and distal right coronary arteries, causes hemodynamic instability. This study was performed to inves tigate the possible role of the Enabler right Ventricular circulatory suppo rt system in counteracting this instability. Methods. In 8 sheep, the Enabler cannula was introduced via the jugular vei n and positioned with the inlet valve in the right atrium and outlet valve in the pulmonary artery. The Octopus was used to expose the inferior wall a nd the posterior wall of the left ventricle. The hemodynamic effects of thi s tilting with and without Enabler right ventricular support were recorded, including Pressure volume (PV) loops measured by conductance catheters in both ventricles. Results. Tilting caused a reduction in stroke volume (inferior 31%, posteri or 17%) and Enabler activation increased stroke volume (inferior 13%, poste rior 31%). Conclusions. Tilting the heart has severe hemodynamic consequences that can be partially counteracted by the use of the Enabler for right ventricle su pport. (C) 1999 by The Society of Thoracic Surgeons.