A novel perfusion catheter for hybrid procedures in minimally invasive bypass surgery

Background: Combined off-pump bypass grafting and percutaneous coronary int ervention (hybrid procedures) is supposed to be beneficial for high-risk pa tients. We developed a novel perfusion catheter to facilitate these hybrid interventions. Methods: First, we tested coagulatory activation in vitro. A fterwards, 6 landrace pigs underwent active coronary perfusion of the LAD. In a second study, 15 pigs underwent off-pump bypass surgery (LIMA to LAD g rafting) and the catheter was used to provide myocardial perfusion and prev ent bleeding at the site of the coronary anastomosis. Results: In the in vi tro perfusion studies, no activation of coagulation or clotting occurred. A ctive coronary perfusion was feasible without signs of regional myocardial ischemia or coagulation over a 50-minute period. During off-pump bypass sur gery, the catheter prevented bleeding in the operation field and facilitate d the surgical procedure. Conclusion: The new perfusion catheter can optimi ze the conditions of off-pump bypass surgery by preventing bleeding in the operation field, maintaining myocardial perfusion and allowing direct angio graphic control of the anastomosis. Therefore, this new technique could be an important tool to facilitate hybrid interventions.