U-Clip Anastomoses in Coronary Artery Bypass Grafting: Initial Clinical Experience


  • Richard J. Shemin
  • Oz M. Shapira
  • Rahul V. Pawar
  • Yusheng Bao
  • Umer Sayeed-Shah
  • Harold L. Lazar




Background: Recent studies suggest that the U-Clip interrupted coronary artery anastomosis is superior to continuous suture. However, clinical experience with this device is limited.

Aim: To evaluate our initial clinical experience with the U-Clip technology.

Methods: Outcomes of 59 patients undergoing isolated coronary artery bypass grafting (CABG) using U-Clips (UCs) were compared to outcomes of 138 patients undergoing CABG using conventional sutures (Conv).

Results: The average number of distal anastomoses was similar in the groups (UC, 2.9; Conv, 3.2; P = .33). Also similar were the number of arterial grafts (1.6 versus 1.5, P = .4), percentage of sequential anastomoses (22% versus 12%, P = .058), and percentage performed off pump (27% versus 28%, P = .74). Cardiopulmonary bypass and aortic cross-clamp times were longer in the UC group (98 ± 27 versus 81 ± 20 minutes, P = .001; 63 ± 25 versus 54 ± 24 minutes, P = .028). Rates of operative mortality (UC, 1.69%; Conv, 0.7%), postoperative myocardial infarction (0% each), stroke (0% each), renal failure (2% versus 1.4%), and blood transfusion (53% versus 58%) were not statistically different. Average follow-up in 36 (61%) of UC patients was 5 ± 2 months (range, 1-7 months). One patient died from a non-cardiac-related cause. At the time of follow-up 90% of patients were in angina class I-II.

Conclusions: The U-Clip interrupted anastomosis technique is versatile and safe and is associated with excellent short-term outcomes.


Bowen CV, Leach DH, Crosby NL, Reynolds R. 1996. Microvascular anastomoses. A comparative study of fibrinogen adhesive and interrupted suture technique. Plast Reconstr Surg 97:792-800.nCaskey MP, Kirshner MS, Alderman EL, et al. 2002. Six-month angiographic evaluation of beating-heart coronary arterial graft interrupted anastomoses using the coalescent u-clip anastomotic device: a prospective clinical study. Heart Surg Forum 5:319-26.nFalk V, Diegeler A, Walther T, et al. 2000. Total endoscopic computer enhanced coronary artery bypass grafting. Eur J Cardiothorac Surg 17:38-45.nGundry SR, Black KB, Izutani H. 2000. Sutureless coronary artery bypass with biologic glue anastomosis: preliminary in vivo and in vitro results. J Thorac Cardiovasc Surg 120:473-7.nHeijmen RH, Hinchliffe P, Borst C, et al. 1999. A novel one-shot anastomotic stapler prototype for coronary bypass grafting on the beating heart: feasibility in the pig. J Thorac Cardiovasc Surg 117:117-25.nHill AC, Maroney TP, Virmani R. 2001. Facilitated coronary anastomosis using a nitinol U-clip device: bovine model. J Thorac Cardiovasc Surg 121:859-70.nLoop FD. 1979. Technique for performance of internal mammary artery-coronary artery anastomosis. J Thorac Cardiovasc Surg 79:460-3.nLoop FD, Lytle BW, Cosgrove DM, et al. 1986. Influence of the internal-mammary-artery graft on 10-year survival and other cardiac events. N Engl J Med 314:1-6.nLytle BW. 2000. Anastomotic techniques. Operative techniques. Thorac Cardiovasc Surg 5:222-30.nNataf P, Kirsch W, Hill AC, et al. 1997. Nonpenetrating clips for coronary anastomosis. Ann Thorac Surg 63:S135-7.nOhtsuka T, Wolf RK, Hiratzka LF, et al. 1997. Thoracoscopic internal mammary artery harvest for MIDCAB using the harmonic scalpel. Ann Thorac Surg 63:S107-9.nOno M, Wolf RK, Angouras D, Schneeberger EW. 2002. Early experience of coronary artery bypass grafting with a new self-closing clip device. J Thorac Cardiovasc Surg 123:783-7.nPhillips AB, Ginsburg BY, Shin SJ, et al. 1999. Laser welding for vascular anastomosis using albumin solder: an approach for MID-CAB. Lasers Surg Med 24:264-8.nTozzi P, Hayoz D, Ruchat P, et al. 2001. Animal model to compare the effects of suture technique on cross-sectional compliance on end-to-side anastomoses. Eur J Cardiothorac Surg 19:477-81.nTulleken CA, Verdaasdonk RM, Mansvelt Beck HJ. 1997. Nonocclusive excimer laser-assisted end-to-side anastomosis. Ann Thorac Surg 63:138-42.n



How to Cite

Shemin, R. J., Shapira, O. M., Pawar, R. V., Bao, Y., Sayeed-Shah, U., & Lazar, H. L. (2005). U-Clip Anastomoses in Coronary Artery Bypass Grafting: Initial Clinical Experience. The Heart Surgery Forum, 6(5), 362-365. https://doi.org/10.1532/hsf.691




Most read articles by the same author(s)