A clinical, prospective trial to evaluate a multi-suture anastomotic device (HeartfloTM) is currently underway. This new surgical tool can be used during CABG to perform end-to-side or side-to-side coronary arteries anastomoses with interrupted suture technique. This reports our interim preliminary clinical experience. Methods: From February to November 2000, we attempted 15 anastomoses with the multi-suture anastomotic device (Heartflo) in 11 patients with coronary artery disease. Results: 7 males, 4 females, mean age 64 ± 3 yrs received 15 anastomoses with the device. The target vessels were: 8 RCA, 3 LAD, 4 OM. Mean coronary diameter was 2 ± 0.3 mm. Grafts used were 14 saphenous veins and 1 IMA. 13/15 anastomoses were completed with the device. 5/13 required 0 - 1 additional stitches versus 8/13 requiring more due to inappropriate tissue capture on the native coronary side. Average time was 17.7 ± 2 min. In 2/15 cases, the procedure was converted to a traditional handsaw anastomosis. Postoperative CK movement without Q-wave in the EKG was observed in 1/11 patients. Conclusions: This device is a reliable instrument that provides reproducible coronary anastomoses with interrupted suture technique, although it also requires additional measures to improve tissue capture and process of handling sutures before extensive clinical application.
Key words:
Vascular anastomosis - Coronary artery bypass
References
-
1
Shennib H, Korkola S J, Bousette N, Giaid A.
An automated interrupted suturing device for coronary artery bypass grafting: automated coronary anastomosis.
Ann Thor Surg.
2000;
70
1046-1048
-
2
Tozzi P, Hayoz D, Ruchat P, Oedman C, Botta U, von Segesser L K.
Animal model to compare the effects of suture technique on cross-sectional compliance on end-to-side anastomoses.
Eur J Cardiothor Surg.
2001;
19
(4)
477-481
-
3
Klein S R, Goldberg L, Miranda R M.
Effect of suture technique on arterial anastomotic compliance.
Arch Surg.
1982;
117
(1)
45-47
-
4
Silber S.
Ten years of arterial closure devices: a critical analysis of their use after PTCA.
Z..
Kardiol;
89
(5)
383-389
-
5
Heijmen R H, Hincliffe P, Borst C. et al .
A novel one-shot anastomotic stapler prototype for coronary bypass grafting on the beating heart: feasibility in the pig.
J.Thorac Cardiovasc Surg.
1999;
117
117-125
-
6
Scheltes Jules S, Heikens M, Pistecky P V, van Andel C, Borst C.
Assesment of patented coronary end-to-side anastomotic devices using micromechanical bonding.
Ann Thorac Surg.
2000;
70
(1)
218-121
1 Presented at the SSCTCV - Zurich, March 2001
Piergiorgio Tozzi, M.D.
Service de Chirurgie CardioVasculaire-BH10
Centre Hospitalier Universitaire Vaudois (CHUV)
Rue du Bugnon, 46
1011 Lausanne
Switzerland
Phone: +41 (21) 314 22 80
Fax: +41 (21) 314 22 78
Email: Tozzig@hotmail.com
