TITLE:
Technique of OPCAB Using Universal Arm
AUTHORS:
Keisuke Morimoto, Tatsuya Higuchi, Yuki Sakaguchi, Futoshi Kobayashi
KEYWORDS:
Coronary Artery Bypass Grafting (CABG), Off-Pump Coronary Artery Bypass (OPCAB), Universal Arm, Tentacles, Minimally Invasive Cardiac Surgery (MICS)
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.15 No.9,
September
23,
2025
ABSTRACT: Objectives: Although there is a debate over whether coronary artery bypass grafting (CABG) should be performed using method off-pump, on-pump, or under cardiac arrest, the off-pump coronary artery bypass (OPCAB) with guaranteed the quality of bypass is considered to have a significant advantage. The purpose of this study is to report on the usefulness of Universal Arm, device for OPCAB, which would contribute to improving the quality of bypass. Methods: Of the 94 CABG cases performed by the first author in our department between April 2019 and August 2024 (all through median sternotomy/under cardiac pulsation), 72 OPCAB cases (off-pump rate of 77%) were included. Two Universal Arms were used, one in combination with a stabilizer as usual, and the other as the fulcrums for lifting and traction of the fixed tubes of Tentacles, which is a suction heart positioner for cardiac decompression. Results: Mean number of bypass branches is 2.9 (1 - 5), grafts used: left internal thoracic artery (LITA) of 70 branches and 2 composite (72/72 patients: 100%), right internal thoracic artery (RITA) of 8 composite (8/72 patients: 11%), radial artery (RA) of 76 branches (54/72 patients: 75%), great saphenous vein (SV) of 57 branches (44/72 patients: 61%), and right gastro-epiploic artery (GEA) of 1 branch (1/72 patient: 1%). Early postoperative total graft patency was 99% (202/204 branches) (LITA 100%, RA 99%, SV 98%, GEA 100%). There was no hospital death, and there were a postoperative (day 5) stroke and ahypoxemia (on a ventilator for 6 days), but no other serious perioperative complications. Two patients underwent an additional percutaneous coronary intervention (PCI) (1 year and 5 years after surgery, respectively), but there were no other cardiac events. Conclusion: Our technique of using the second Universal Arm applied to the fulcrums for lifting and traction of the fixed tubes of Tentacleswas considered useful for performing OPCAB.