The Octopus II (TM) stabilizing system: Biochemical and neuropsychologicaloutcomes in coronary artery bypass surgery

Background: The aim of this study was to determine if coronary artery bypas s graft (CABG) surgery performed utilizing the Octopus II(TM) stabilizing s ystem provides myocardial and cerebral protection comparable to traditional CABG surgery utilizing cardiopulmonary bypass (CPB). Methods: Elective patients requiring surgery for double or triple vessel di sease were randomized to receive either conventional CABG with CPB (n = 14) or OPCAB using the Octopus II(TM) stabilizing system (n = 12), after recei ving institutional approval and written consent. Exclusion criteria include d previous cardiac surgery, recent myocardial infarction, and previous cere brovascular disease. Troponin T (TnT) was measured preoperatively and at 2, 4, 6, 8, 10, 12, 24, and 72 hours after initiation of grafting. Neuropsych ological assessments (10 measures) were performed in the week prior to surg ery, one week, and six months after surgery. Results: Troponin T release was reduced in the OPCAB patients at all time p oints (repeated measures ANOVA p = 0.043), reaching significance at 8, 10 a nd 12 hours (p = 0.033, 0.038, 0.019). Other factors (composite clinical en d point (prolonged LOS or ICU stay or 30-day mortality), infarction, and in tubation time) did not show any significant differences between the two gro ups. The incidence of neuropsychological deficits was not different between the two groups at both seven-day and six-month follow-up assessments. Conclusions: Decreased TnT release suggests a myocardial benefit for the OP CAB procedure. A neuropsychological benefit remains to be demonstrated.