The enables right ventricular circulatory support system for beating heart coronary artery bypass graft surgery

Background. Beating heart coronary artery bypass graft surgery of the left anterior descending, diagonal, and right coronary artery can be performed safely with the Octopus Stabilization System. However, tilting of the heart, which is necessary to reach the obtuse marginal and distal right coronary arteries, causes hemodynamic instability. This study was performed to investigate the possible role of the Enabler right Ventricular circulatory support system in counteracting this instability. Methods. In 8 sheep, the Enabler cannula was introduced via the jugular vein and positioned with the inlet valve in the right atrium and outlet valve in the pulmonary artery. The Octopus was used to expose the inferior wall and the posterior wall of the left ventricle. The hemodynamic effects of this tilting with and without Enabler right ventricular support were recorded, including Pressure volume (PV) loops measured by conductance catheters in both ventricles. Results. Tilting caused a reduction in stroke volume (inferior 31%, posterior 17%) and Enabler activation increased stroke volume (inferior 13%, posterior 31%). Conclusions. Tilting the heart has severe hemodynamic consequences that can be partially counteracted by the use of the Enabler for right ventricle support. (C) 1999 by The Society of Thoracic Surgeons.