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CARDIOVASCULAR
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Volume 6, 2001, No 1 |
Right
Heart Support, Percutaneous Assist Devices - What is New?
H. Reul
OPCAB has steadily grown in popularity, as a possible means of reducing the morbidity and costs of standard CPB-supported procedures. In order to operate on a beating heart, special care must be taken to expose, visualize, and stabilize the target vessel location. Surgical techniques, such as deep pericardial sutures, slings, and rotation of the patient on the surgical table are utilized to gain proper exposure to perform the bypass, and mechanical stabilizers are applied to create a still field for performing the anastomosis. All of these measures help facilitate the OPCAB procedure. But they do not adequately address one of the remaining challenges to the beating heart technique: hemodynamic instability during revascularization of inferior and posterior wall vessels. The state of OPCAB surgery suggests that there may be a need for circulatory support which ideally is less invasive than the traditional CPB circuit and helps to maintain the hemodynamic stability of the patient. Currently, there are three different devices of a new generation of circulatory support systems available which address this problem. Their indications, technical specifications and clinical data are presented in some detail.
(CVE. 2001; 6 (1): 3-7)
Key words: coronary artery disease, hemodynamic instability, circulatory support
Prof.
Helmut Reul, M.D.
Helmholtz-Institute for Biomedical Engineering at the RWTH-Aachen
Pauwelsstr. 20
D-52074 Aachen
Germany
E-mail: reul@hia.rwth-aachen.de
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