Epicardial hematoma and myocardial ischemia following application of Starfish stabilizer: an uncommon complication of the device

The Starfish heart positioning device allows excellent cardiac positioning and hemodynamic stability during off-pump coronary artery bypass graft surgery. Herein, we present a patient in whom the use of this device caused epicardial hematoma as the result of an injured epicardial vein, an uncommon complication of this device. In this patient, regional left ventricular wall motion abnormality on transesophageal echocardiography and a ST-T change on electrocardiogram occurred secondary to the development of the epicardial hematoma. These signs completely disappeared upon removal of the hematoma. These findings suggested that the hematoma resulted in reversible myocardial ischemia.