Coronary artery bypass grafting without cardiopulmonary bypass using the octopus method: results in the first one hundred patients

J Thorac Cardiovasc Surg. 1998 Jul;116(1):60-7. doi: 10.1016/S0022-5223(98)70243-0.


Objective: Cardiopulmonary bypass and global cardiac arrest enable safe coronary artery bypass grafting but have adverse effects. In off-pump coronary bypass grafting, invasiveness is reduced, but anastomosis suturing is jeopardized by cardiac motion. Therefore the key to successful off-pump coronary bypass grafting is effective local cardiac wall stabilization.

Methods: We prospectively assessed the safety and efficacy of the Octopus tissue stabilizer (Medtronic, Inc., Minneapolis, Minn.) in the first 100 patients selected for off-pump coronary bypass via full or limited surgical access. To immobilize and expose the coronary artery, two suction paddles (-400 mm Hg), fixed to the operating table-rail by an articulating arm, stabilized the anastomosis site.

Results: One hundred forty-one grafts (96% arterial) were used to create 172 anastomoses (17% side-to-side), up to 4 per patient, on average 23 in the full access group (46 patients) and 1.2 in the limited access group (54 patients). Complications included conversion to cardiopulmonary bypass (2%), conversion from limited to full access (3%), myocardial infarction (4%), predischarge coronary reintervention (2%), and late coronary reintervention (1%). Median postoperative length of hospital stay was 4 days (limited access) or 5 days (full access). Rapid recovery allowed 96% of patients to resume social activities within 1 month. At the 6-month angiographic follow-up, 95% of anastomoses was patent. At the 2- to 22-month follow-up (mean, 13 months), 98 patients were in Canadian Cardiovascular Society class I and 2 patients were in class II.

Conclusion: These results suggest that off-pump coronary artery bypass grafting with the Octopus tissue stabilizer is safe. Early clinical outcome and patency rates warrant a randomized study comparing this methods with conventional coronary bypass grafting.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiopulmonary Bypass*
  • Contraindications
  • Coronary Angiography
  • Coronary Artery Bypass / methods*
  • Coronary Disease / complications
  • Coronary Disease / diagnostic imaging
  • Coronary Disease / surgery*
  • Electrocardiography
  • Equipment Design
  • Exercise Test
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Postoperative Complications
  • Prospective Studies
  • Safety
  • Suture Techniques
  • Treatment Outcome
  • Ventricular Dysfunction, Left / complications