US surgeon performs first beating heart fully endoscopic bypass surgery using miniaturised Maquet’s cardiopulmonary bypass system

68

Maquet Cardiovascular announced on 24 September 2009 that Johannes Bonatti, professor of surgery and director of coronary surgery and advanced coronary interventions at the University of Maryland Heart Center in Baltimore, US, has completed the first use of the Maquet Minimised ExtraCorporeal Circulation (MECC) system in the US during a successful robotic and fully endoscopic heart surgery.

According to Maquet, the new cardiopulmonary bypass technology is the first major advancement in perfusion technology in the last decade. It is designed to minimise the effects of traditional heart surgery and aid in minimally invasive heart surgery without the need to stop the patient’s heart from beating.


“The difficulty in performing robotic beating heart bypass surgery safely and comfortably on a patient has been a barrier to the growth of minimally invasive procedures, despite their benefits to patients over more open approaches,” said Bonatti. “A miniaturised cardiopulmonary bypass system, such as Maquet’s MECC technology, provides alternatives to surgeons performing robotic surgery and allows patients who were previously not a candidate to receive minimally invasive interventions.”


Bonatti has been recognised as one of the world’s thought-leaders in the growing field of totally endoscopic coronary surgery. Through his use of robotic surgical equipment, Bonatti offers his patients an alternative to open surgery that has been demonstrated to reduce overall recovery time and enable patients to return to their daily activities significantly faster than with traditional bypass surgery.


Traditional bypass surgery uses a standard heart lung bypass machine with catheters inserted directly into the patient’s heart. The heart is stopped, allowing the surgeon a static area in which to sew and connect bypass grafts. However, it has been demonstrated that outcomes can potentially be improved if the heart is not stopped.


The MECC system, in contrast, typically requires the placement of two catheters in the patient’s upper thigh and does not require the surgeon to stop the patient’s heart during surgery. The combined effect of allowing the heart to remain beating, the reduction of tubing needed, and the reduced amount of fluid required to dilute the blood versus that needed in traditional bypass, offers improved safety and the ability to offer a minimally invasive approach to the patient. Diluting the patient’s blood during routine bypass surgery has been associated with an increased need for blood transfusions. MECC technology requires only a small amount of fluid to be given to the patient and, therefore, decreases the likelihood of a necessary blood transfusion.