An Automatic Sutureless Coronary Anastomotic Device: Initial Results of an Animal Study

Authors

  • Yaron Bar-El
  • Fermin O. Tio
  • Rona Shofti

DOI:

https://doi.org/10.1532/hsf.605

Abstract

Background: The efficacy and long-term patency of a new distal anastomotic device (DAD) for the creation of rapid, sutureless end-to-side venous or arterial coronary artery bypass graft anastomoses were tested in a sheep model.

Methods: The DAD was used on the beating hearts of 34 sheep to create 20 anastomoses between saphenous veins (n = 9) or internal mammary arteries (n = 11) and various coronary arteries. Fourteen conventional hand-sutured anastomoses (7 veins; 7 internal mammary arteries) served as controls. The sheep were sacrificed 1 day, 1 week, and 1, 3, and 6 months after surgery.

Results: The immediate patencies of all anastomoses were proven by the rates and pattern of flow. There were no significant differences between the DAD and suture anastomosis groups in presacrifice pulsatility index and occlusion rate. The histomorphometric studies showed complete intimal bridging over the DAD with no significant differences between DAD and suture anastomoses with respect to tissue response, mural injury, inflammation, and adventitial fibrosis.

Conclusions: The DAD enables the creation of rapid, efficient, and sutureless venous or arterial coronary anastomoses. The long-term results of histomorphometric studies show that the results with the DAD are comparable with those of conventional hand-sutured anastomoses.

References

Schurmann K, Vorwerk D, Kulisch A, et al. 1996. Neointimal hyperplasia in low-profile nitinol stents, Palmaz stents and Wallstents: a comparative experimental study. Cardiovasc Intervent Radiol 19:248-54.nSchwartz RS. 1999. Animal models of human coronary restenosis. In: Topol EJ, editor. Textbook of interventional cardiology. 3rd ed. Philadelphia, Pa: W. B. Saunders. p 358-78.nSchwartz RS, Edwards WD, Huber KC, et al. 1993. Coronary restenosis: prospects for solution and new perspectives from a porcine model. Mayo Clin Proc 68:54-62.nShennib H. 2001. A renaissance in cardiovascular surgery: endovascular and device-based revascularization. Ann Thorac Surg 72:S993-4.nSubramanian VA, Fonger JD, Connolly MW. 2002. Facilitated vascular anastomosis in coronary bypass surgery. Semin Thorac Cardiovasc Surg 14:89-100.nWerker PM, Kon M. 1997. Review of facilitated approaches to vascular anastomosis surgery. Ann Thorac Surg 63(suppl):S122-7.nWhite JG, Mulligan NJ, Gorin DR, D'Agostino R, Yucel EK, Menzoian JO. 1998. Response of normal aorta to endovascular grafting: a serial histopathological study. Arch Surg 133:246-9.nWilensky RI, March KL, Gradus-Pizlo I, Sandusky G, Fineberg N, Hathaway DR. 1995. Vascular injury, repair, and restenosis after percutaneous transluminal angioplasty in the atherosclerotic rabbit. Circulation 92:2995-3005.n

Published

2005-02-08

How to Cite

Bar-El, Y., Tio, F. O., & Shofti, R. (2005). An Automatic Sutureless Coronary Anastomotic Device: Initial Results of an Animal Study. The Heart Surgery Forum, 6(5), 369-374. https://doi.org/10.1532/hsf.605

Issue

Section

Articles