Evaluation of Hemodynamics: Comparison of Vacuum and Mechanical Stabilization in the Beating Heart

Authors

  • Daniel J. Beckman
  • Karen Bumb
  • Maria Bandy
  • Maria Evans
  • Cindy Romanyk

DOI:

https://doi.org/10.1532/hsf.952

Abstract

Background: Hemodynamic instability remains a prominent concern for surgeons performing coronary surgery without cardiopulmonary bypass. The purpose of this study was to further elucidate the mechanism of hemodynamic instability by comparing vacuum stabilization to mechanical stabilization.

Methods: Four 60-kg swine were placed under general anesthesia. A median sternotomy incision was made, and baseline hemodynamic measurements were recorded. Mechanical and vacuum stabilization of the circumflex distribution were alternately compared with repeated baseline measurements in a counterbalanced method, and 32 experiments were conducted.

Results: There were significant differences between baseline hemodynamics and stabilized hemodynamics for mechanical stabilization versus vacuum stabilization, respectively, for the following parameters: blood pressure (mean decrement), -32.18% (P = .0028) versus -31.3% (P = .0006); cardiac output, -31.03% (P = .0046) versus -35.2% (P = .03); and mixed venous oxygen saturation, -29.8% (P = .008) versus -27.4% (P = .0004). There were no statistical differences between mechanical and vacuum stabilization when their decremental effects on baseline hemodynamics were compared with each other for any of the measured variables.

Conclusions: The mechanisms of hemodynamic compromise during coronary stabilization remain to be fully elucidated. Our study demonstrates no statistical difference between vacuum and mechanical stabilization on the measured hemodynamic values. More sophisticated studies involving detailed analysis of motion and geometry are required so that technical solutions to hemodynamic instability can be developed.

References

Burfeind WR Jr, Duhaylongsod FG, Samuelson D, Leone BJ. 1998. The effects of mechanical cardiac stabilization on left ventricular performance. Eur J Cardiothorac Surg 14:285-9.nDetter C, Deuse T, Christ F, Boehm DH, Reichenspurner H, Reichart B. 2002. Comparison of two stabilizer concepts for off-pump coronary artery bypass grafting. Ann Thorac Surg 74:497-501.nJansen EW, Borst C, Lahpor JR, et al. 1998. Coronary artery bypass grafting without cardiopulmonary bypass using the octopus method:nresults in the first one hundred patients. J Thorac Cardiovasc Surg 116:60-7.nJurmann MJ, Menon AK, Haeberle L, Salehi-Gilani S, Ziemer G. 1998. Left ventricular geometry and cardiac function during minimally invasive coronary artery bypass grafting. Ann Thorac Surg 66:1082-6.nMathison M, Edgerton JR, Horswell JL, Akin JJ, Mack MJ. 2000. Analysis of hemodynamic changes during beating heart surgical procedures. Ann Thorac Surg 70:1355-60; discussion 1360-1.nMueller XM, Chassot PG, Zhou J, et al. 2002. Hemodynamics optimization during off-pump coronary artery bypass: the "no compression" technique. Eur J Cardiothorac Surg 22:249-54.nShennib H, Lee AG, Akin J. 1997. Safe and effective method of stabilization for coronary artery bypass grafting on the beating heart. Ann Thorac Surg 63:988-92.n

Published

2005-02-07

How to Cite

Beckman, D. J., Bumb, K., Bandy, M., Evans, M., & Romanyk, C. (2005). Evaluation of Hemodynamics: Comparison of Vacuum and Mechanical Stabilization in the Beating Heart. The Heart Surgery Forum, 6(4), 220-223. https://doi.org/10.1532/hsf.952

Issue

Section

Articles

Most read articles by the same author(s)