Prairie Heart among first worldwide to use latest technology to perform "beating heart" surgery

SPRINGFIELD -- The Prairie Heart Institute at St. John's was selected as the first hospital in the world to perform a double bypass operation using the latest technology in "beating heart" surgery. The device, recently approved by the U.S. Food and Drug Administration, is called the Enclose Cardiac Anastomosis Assist Device, by Novare Surgical Systems, Inc. It offers the cardiac surgeon an alternative to traditional clamping methods while attaching the bypass vessel to the aorta.

According to cardiothoracic surgeon Carl Arentzen, M.D., of the Prairie Heart Institute, who performed four bypass operations using the device, the innovative design allows the surgeon to sew grafts onto the aorta with less potential damage to the vessel while allowing virtually unimpeded blood
flow through the aorta.

"Typically, surgeons use conventional steel clamps that are increasingly viewed as an important cause of vessel trauma and post-operative complications in off-pump bypass surgery," said Dr. Arentzen. "This simple, innovative device decreases the risk of major neurologic complications by allowing us to use the standard suture technique without clamping the aorta."

Arentzen said the Prairie Heart Institute was selected as a site because of the lengthy experience surgeons there have performing "beating heart" surgery. The Cleveland Clinic is the other hospital to have used the device. Arentzen said his four bypass patients are doing well.

The Enclose device is a small, hand-held device comprised of three elements: a rigid two-inch catheter that is inserted into the aorta, a metallic fork that is lowered onto the exterior of the aorta, and a small plastic grip that houses a lever and a knob. In use, the catheter part is slipped into the aorta via a simple needle stick. Once within the aorta's lumen, the surgeon turns the lever to cause the distal tip of the rigid catheter to expand laterally. The result is the formation of a 1 square centimeter elastic, blood-tight membrane.

Next, the surgeon turns a knob that causes the external metallic forks to be lowered onto the external wall of the aorta. The forks descend immediately over, but external to the area where the deployed membrane resides inside the aorta. The resultant effect is the isolation and enclosure of 1 square centimeter of the aortic wall from blood flow. This enclosed area allows the surgeon to work in a bloodless field to create an opening in the fully pressurized aorta and, using standard suturing techniques, create a connection of a vein graft to the aorta.