ObjectiveTo investigate the effects of cardiac positioner device in off-pump coronary artery bypass grafting.

MethodsA total of 80 patients with multi-vessel coronary artery disease diagnosed by angiography were randomly divided into the cardiac positioner group and control group(40 cases in each group).The apical aspirator was used to assist the coronary artery bypass grafting in the apical aspirator group, while the conventional cardiac exposure was used in the control group.The mean arterial pressure, heart rate, central venous pressure and pulmonary artery wedge pressure in two groups were recorded at the beginning of surgery(T0), before coronary artery bypass(T1), when the heart position was changed(T2) and when the heart was placed back into the pericardial cavity(T3).The levels of the cardiac markers troponin I(cTnI), troponin T(cTnT) and N-terminal pro-brain natriuretic peptide(NT-probNP), time of bypass and operation, success rate of one anastomosis, amount of norepinephrine during bypass, incidence of arrhythmia, bleeding volume during operation, amount of intraoperative and postoperative complications in two groups were recorded before operation and after 24 h of operation.

ResultsWhen the target vessel in the lateral wall and inferior wall in the cardiac positioner group were anastomosed, the hemodynamics was more stable, the arrhythmia was lower incidence and the dosage of norepinephrine was less(P < 0.01), and the target vessels were well exposed, the bleeding was less and the bypass time was short(P < 0.01).At 24 h after operation, the cardiac function indexes of two groups increased(P < 0.01), and the cTnT and NT-probNP in apical suction group were lower than those in control group(P < 0.05).Compared with the control group, the mechanical ventilation time and ICU stay time were shorter, and the incidence rate of adverse reactions was lower in the cardiac positioner group(P < 0.05 to P < 0.01).

ConclusionsThe application of apical positioner device in off-pump coronary artery bypass grafting is beneficial to the exposure and accurate anastomosis of target vessels, and can improve the intraoperative hemodynamics and postoperative cardiac function.