Coronary Artery Bypass with the Use of a Magnetic Distal Anastomotic Device: Surgical Technique and Preliminary Experience
Background: At present there is little reported experience in the application of new technology in the performance of distal coronary anastomoses in the clinical setting. The aim of our study was to evaluate the feasibility of using the Ventrica magnetic vascular positioner (MVP) device for left internal thoracic artery (LITA)-to-left anterior descending (LAD) coronary anastomosis.
Methods: We present our preliminary experience of the first 14 coronary artery cases performed in the United Kingdom from April 2003 to December 2003. The selection criteria, surgical technique, clinical outcome, advantages or disadvantages, and future implications are all discussed.
Results: The device was used in 12 patients for LITA-to-LAD anastomosis and in 2 patients for the proximal anastomosis of a radial artery Y-graft from the LITA to the circumflex territories. The first 3 patients underwent coronary artery bypass graft with the use of cardiopulmonary bypass, and the remaining 9 underwent surgery performed using an off-pump coronary artery bypass technique. No mortality or device-related events were observed in these patients. The anastomosis time in our series was 5.6 ± 1.99 minutes, and the blood loss was 914 ± 234 mL. The mean length of stay was 5.8 ± 1.16 days.
Conclusion: The MVP system is a novel distal coronary anastomotic device that is quick, simple, and effective, producing consistently reliable coronary anastomoses in a wide variety of coronary bypass procedures. Early results are encouraging, and further studies are required in order to evaluate long-term efficacy of this system in the rapidly changing world of coronary revascularization.
Adams DH, Filsoufi F, Aklog L, et al. 2002. Automated distal coronary bypass using a novel magnetic coupler. American Association for Thoracic Surgery 82nd Annual Meeting, Washington, DC, May 5-8, 2002; T2(Abstract):230.nDetweiler MB, Detweiler JG, Fenton J. 1999. Sutureless and reduced structure anastomosis of hollow vessels with fibrin glue: a review. J Invest Surg 12:245-62.nFalk V, Walther T, Stein H, et al. 2003. Facilitated endoscopic beating heart coronary artery bypass grafting using a magnetic coupling device. J Thorac Cardiovasc Surg 126:1575-9.nFilsoufi F, Farivar RS, Aklog L, et al. 2004. Automated distal coronary bypass with a novel magnetic coupler (MVP system). J Thorac Cardiovasc Surg 127(1):185-92.nKlima U, Falk V, Maringka M, et al. 2003. Magnetic vascular coupling for distal anastomosis in coronary artery bypass grafting: a multicenter trial. J Thorac Cardiovasc Surg 126:1568-74.nLytle BW, Blackstone EH, Loop FD, et al. 1999. Two internal thoracic artery grafts are better than one. J Thorac Cardiovasc Surg 117(5):855-72.nScheltes JS, Heikens M, Pistecky PV, van Andel CJ, Borst C. 2000. Assessment of patented coronary end-to-side anastomotic devices using micromechanical bonding. Ann Thorac Surg 70:218-21.n
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