Thorac Cardiovasc Surg 2014; 62 - SC41
DOI: 10.1055/s-0034-1367302

New clip remover device to prepare saphenous vein graft for coronary bypass grafting

O. Dzemali 1, A. Häussler 1, D. Odavic 1, A. Zientara 1, H. Loeblein 1, M. Genoni 1
  • 1Universitäres Herzzentrum Zürich, Klinik für Herzchirurgie, Zürich, Switzerland

Objective: The accurate prepare of the saphenous vein (SV) is elementary to have good patency rates in myocardial revascularisation. To avoid intimal hyperplasia we use the eSVS Mesh (Kipps Bay Medical™, Minneapolis, USA). Caused by endoscopic harvesting technique of SV all side branches are clipped in situ. All Clips have to be removed and replaced by fine sutures (Prolene 6-0) in order to enable the covering the SV with the eSVS. How to remove the Clips without tearing the SV and its intima?

Methods: We use a new designed clip remover in 40 patients. After harvesting the SV the distal end is intubated by a cannula with outlet. Into the SV a solution of sodium chloride 0.9% is applicated with a maximum pressure of 150 cm H2O. So the clips are exposed in a good position and they can be reopened and removed without sheer stress to the tissue by the clip remover device. Intraoperative graft patency was verified by MediStim.

Result: All clips could be removed from vein. No tear that had to be repaired. Graft patency was 95% for eSVS treated with the new device. Histologic findings showed no intima lesions.

Conclusion: This new tool is very feasible and save. Wrong placed clips on mammarian artery or veins are now easy and safely removable and a new can be applicated in correct position considering the potential intima lesion of the graft by clipping.