Adjunct tools in OPCAB surgery

Abstract

No matter what the specific technique, constructing perfect anastomoses remains the basic prerequisite for successful coronary revascularization. During an OPCAB procedure, the following steps are required to construct an adequate anastomosis: 1) ensure stable cardiovascular dynamics, 2) obtain ergonomically favorable exposure of the target area, 3) guarantee optimal stabilization of the cardiac surface without compromising hemodynamic stability, 4) expose the coronary vessel in a practically bloodless manner while avoiding any ischemic response. Beating-heart procedures are much more challenging for the surgeon than operations on the arrested heart. By now an extensive arsenal of surgical tools has become available to support surgeons in their technically demanding endeavor. Topics such as techniques for intraoperative stabilization of the heart and the benefit of using a pacemaker with epicardial electrodes are comprehensively covered in other chapters.