Beating heart surgery using the Octopus (TM) tissue stabilizers: Initial experience including triple vessel disease and high-risk patients

Objective : The aim of this study was to evaluate initial results in beatin g heart coronary artery bypass grafting pet-formed on patients with multive ssel disease, using suction-based tissue stabilizers. Methods : Forty patients (mean age 65.5 years, range 39-83) underwent beati ng heart coronary bypass by median sternotomy. with the use of the Octopus( TM) 1 (n = 27) and Octopus(TM) 2 (n = 13) devices. Twenty patients had unst able angina. four had pulmonary oedema, and four required preoperative intr a-aortic balloon counterpulsation. Five interventions were repeat procedure s. Mean ejection fraction was 54.4%(range 20-82%). Eighteen patients had tr iple-vessel disease, 18 patients had double-vessel disease and > 50% left m ain stem stenosis was present in six patients (isolated or in association). The average number of distal anastomoses was 2.5 (range 1-5. total 101). A mean of 1.5 (range 1-3) anastomoses was achieved with arterial grafts (45 mammary and 12 gastroepiploic arteries). Results : Immediate graft patency was evaluated by Doppler flowmeter and fi ve anastomoses were successfully corrected, based on an occlusion pattern. The perioperative myocardial infarction rate was zero. Transient episodes o f supraventricular arrhythmias were detected in 19 patients. The administra tion of dobutamine at an inotropic concentration > 5 gamma (-1) kg(-1) min( -1) was required in one patient. There were two in-hospital deaths (one non -cardiac-related). Overall survival and cardiac event-free rate at 20 month s were 92.4% +/- 4.2% and 81.8% +/- 11.6%, respectively. Conclusions : Satisfactory results can be achieved in multivessel disease h igh-risk patients with beating heart coronary bypass surgery.