New method for accurate ECG trigger of intraaortic balloon counterpulsation during off-pump coronary artery bypass surgery

BACKGROUND: Retractions of the heart required for exposure and construction of distal anastomoses often decrease R-wave amplitude of ECG and interfere with intraaortic balloon pump (IABP) trigger during off-pump coronary artery bypass (OPCAB). Missing R wave trigger results in asynchronous work of IABP and probably produces hemodynamic instability. We report our early experience with a new interface BPI 202 (Osypka Medical, Inc., USA) for sensing accurate ECG trigger for IABP during OPCAB procedure. CASES: Six high-risk patients undergoing multivessel OPCAB using BPI 202 are described. RESULTS: With the new interface BPI 202, simulated R wave signal could be processed from an external dual chamber pacemaker sensing surface R wave. The simulated R wave was successfully used for controlling IABP and secured a synchronous work between the heart and IABP during heart retraction maneuver. BPI 202, an interface for IABP appeared to facilitate the intraoperative management of our series of patients. CONCLUSIONS: We believe BPI 202 can produce a synchronous work of IABP during OPCAB procedures to high-risk patients and avoid dangerous hemodynamic instability.