Olivier Bouchot1, Jean Pierre Berne1, Robert L. Berger2, Roger Brenot1, Michel David1.
1CHU Le Bocage, Dijon, France, 2Department of Surgery, Harvard Medical School, Boston, MA, USA.
OBJECTIVE: Currently employed vascular clamps may cause tissue damage and can be inefficient by allowing blood flow especially in diseased vessels. In preclinical studies, a thermosensitive gel (LeGoo™) proved safe, atraumatic and effective in terms of providing complete interruption of blood flow with a bloodless operative field. We are reporting the preliminary results from the first human experience with LeGoo™ during OPCAB
METHODS:
LeGoo™ was employed for temporary blood flow interruption in 12 patients (26 coronary arteries) during OPCAB surgery . The occluded coronary arteries (#26) included: left anterior descending (#11), right (#5), circumflex (#4), marginal (4) and diagonal (#2).
RESULTS:
All operations were elective, and the mean age of patients was 70±7 years. All anastomoses were completed without difficulty using LeGoo as the sole mean for obtaining flow interruption. The average duration of occlusion was 13±3.5 minutes. A second injection was necessary for 15 proximal and 11 for distal coronary occlusions. The mean volume used was 0.3± 0.14 ml for the proximal injection and 0.18 ± 0.09 ml for the distal injection.
One patient presented transitional arrhythmia (ventricular fibrillation) after 20 minutes occlusion of the right coronary artery.
The post operative peak Troponin level was 2.70 ±3,68 UI. Two patients with moderate elevation showed no EKG or echocardiographic changes suggestive of myocardial injury.
No abnormal bleeding, coagulopathy or evidence of organ damage were observed.
CONCLUSIONS:
In this first human experience LeGoo™ provided safe, atraumatic and highly effective temporary flow interruption in small arteries during OPCAB, obviating the need for conventional vascular clamps with a potential for tissue injury and incomplete occlusion.
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