Beating Heart Surgery - Stablilization

STABILIZATION

Target area stabilization is important for achieving a precise anastomosis on a beating heart.

Suction

Suction technology (e.g., Octopus¨2 Tissue Stabilization System) provides secure attachment of the stabilizers to the epicardium. Lifting and separating the stabilizer heads pulls tissue taut to isolate and immobilize the target area (Figure 6). Optimal stabilization is provided with motion reduction in all three planes (X, Y, Z).^11,17

"Suction is a splendid idea because it avoids major compression and still keeps a stable field."¹³ - F.W. Mohr, M.D.

Figure 6. The Octopus®2 Tissue Stabilizer immobilizes the target area by lifting the epicardium and pulling the tissue taut.

The motion reduction capabilities of the Octopus Tissue Stabilization System are depicted in Figure 7.

Compression

Compression stabilizers use downward force to compress the myocardium and restrict its motion (Figure 8). In fact, cardiac output has been shown to be temporarily decreased as a result of direct ventricular compression with reduced stroke volume.¹⁹

Figure 8. Compression stabilizers restrict the motion of the myocardium.

Figure 7. A calibrated beacon directed at the unrestricted LV free wall creates the elliptically shaped pattern. The pattern represents 1/2 of a respiratory cycle and four cardiac cycles. Unrestricted motion in the X and Y planes is calculated at 73 mm² ± 43.0 mm². The inset shows the residual motion of the same area after attachment of the Octopus Tissue Stabilization System at 1.3 mm ² ± 0.5 m². Excursions in the Z direction were estimated to be 1Ð3 mm.¹⁸