Background and purpose: Minimally invasive coronary artery bypass grafting
(CABG) has been facilitated by the introduction of the Octopus Tissue Stabi
lization system (OTS). OTS improves exposure immobilizing the heart with mi
nimal hemodynamic effects allowing multivessels off cardiopulmonary bypass
(CPB) CABG. The purpose of this study was to compare the utilization and cl
inical outcome of the OTS in three geographically distinct centers. Methods
: 239 patients who underwent OTS-CABG at Allegheny University Hospital/Medi
cal College of Pennsylvania, Harrisburg Hospital, and Park Nicollet Clinic/
HealthSystem Minnesota were reviewed. Age, acuity of patients, and number a
nd type of vessels bypassed were recorded. Complications, mortality, length
of hospital stay, incidence of conversion to CPB and blood transfusions, a
nd operating room costs were compared to risk matched control patients who
underwent CPB CABG during the same period. Results: Results were similar in
all three centers. The average age was 62.3 years. Emergent operation was
necessary in 7%-10% of patients, the operations averaged 1.8 grafts/patient
. Arteries bypassed were LAD, DIAG, OM, RCA, PDA, and RPLB. There were 96%
of operations completed without CPB. Morbidity was low (12%). Atrial fibril
lation and blood transfusion rate were decreased. Mortality was 0 compared
with a predicted mortality of 1.6%. Hospital length of stay was shorter and
operating room costs were 61% lower. Conclusions.. OTS provides predictabl
e reproducible immobilization allowing the performance of single and multip
le off-pump CABG to almost all coronary branches with minimal morbidity and
decreased costs in a variety of patients. Similar findings from three diff
erent centers suggests that these results are easily reproducible.