M K Dullum1, F G Resano. 1. Washington Hospital Center and Washington Adventist Hospital, Washington, DC 20010, USA. mkcd@erols.com
Abstract
BACKGROUND: Off-pump coronary artery bypass (OPCAB) is gaining acceptance and is now more widely used for coronary revascularization. Accessing the vessels, particularly on the lateral and inferior walls of the heart, can sometimes be challenging while the heart is beating. CASE REPORTS: The Xpose Access Device (Xpose; Guidant Corporation, Cupertino, Ca.) was used in 5 patients undergoing beating heart surgery to position the heart for coronary grafting. Hemodynamic and mixed venous oxygen saturation (MVO2) monitoring was performed with the device in place. In all cases, Xpose was successfully used to easily access and graft all of the target vessels including lateral and inferior wall vessels with the patients maintaining stable hemodynamic performance. CONCLUSION: Xpose was used to successfully perform multivessel coronary bypass on all walls of the beating heart. These case reports suggest that use of the Xpose will facilitate and expand the ability to easily and consistently perform coronary artery bypass grafting on the beating heart.
BACKGROUND: Off-pump coronary artery bypass (OPCAB) is gaining acceptance and is now more widely used for coronary revascularization. Accessing the vessels, particularly on the lateral and inferior walls of the heart, can sometimes be challenging while the heart is beating. CASE REPORTS: The Xpose Access Device (Xpose; Guidant Corporation, Cupertino, Ca.) was used in 5 patients undergoing beating heart surgery to position the heart for coronary grafting. Hemodynamic and mixed venous oxygen saturation (MVO2) monitoring was performed with the device in place. In all cases, Xpose was successfully used to easily access and graft all of the target vessels including lateral and inferior wall vessels with the patients maintaining stable hemodynamic performance. CONCLUSION: Xpose was used to successfully perform multivessel coronary bypass on all walls of the beating heart. These case reports suggest that use of the Xpose will facilitate and expand the ability to easily and consistently perform coronary artery bypass grafting on the beating heart.