Sutureless coronary anastomosis with an anastomotic device and tissue adhesive in off- pump porcine coronary bypass grafting Marc P. Buijsrogge, MDa,

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Presentation transcript:

Sutureless coronary anastomosis with an anastomotic device and tissue adhesive in off- pump porcine coronary bypass grafting Marc P. Buijsrogge, MDa, Jules S. Scheltes, MScb, Martijn Heikens, BScb, Paul F. Gründeman, MD, PhDa, Peter V. Pistecky, MScb, Cornelius Borst, MD, PhDa The Journal of Thoracic and Cardiovascular Surgery Volume 123, Issue 4, Pages 788-794 (April 2002) DOI: 10.1067/mtc.2002.120336 Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Crinoline-adhesive anastomotic procedure. A, Crinoline-like bonding device consists of stainless steel ring-shaped frame (outside diameter 6.0 mm) and four downward axially extending hook elements (length 8.0 mm) with thickenings at end. Hook elements are elastically bendable. B, End of graft, cut at 90° angle, is passed through orifice of ring, everted, and impaled over hook elements, which results in slight lumen area reduction. Thickenings near tip of elements prevent graft from sliding upward. C and D, Mounted crinoline is hooked in coronary artery in intima-intima apposition of graft and recipient artery. E, In response to radially directed forces of the elements, anastomotic line of end-to-side anastomosis is slightly stretched, after which fixed apposition is consolidated by adhesive. The Journal of Thoracic and Cardiovascular Surgery 2002 123, 788-794DOI: (10.1067/mtc.2002.120336) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Representative angiogram at 5 postoperative weeks. Note external ring frame of prototype crinoline mechanical coupler. The Journal of Thoracic and Cardiovascular Surgery 2002 123, 788-794DOI: (10.1067/mtc.2002.120336) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Representative longitudinal histologic section of toe of crinoline-adhesive anastomosis at 5 postoperative weeks, demonstrating streamlining intimal hyperplasia (IH) over anastomotic recess formed by intima-intima apposition. Blank space between adhesive (adhesive void, A) and graft corresponds to position of hook element after its removal. LITA, Left ITA. Bar represents 250 μm. (Elastin van Gieson stain; original magnification x100.) The Journal of Thoracic and Cardiovascular Surgery 2002 123, 788-794DOI: (10.1067/mtc.2002.120336) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions