HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Paul F. Gründeman Cornelius Borst Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Buijsrogge, M. P. Articles by Borst, C. Search for Related Content PubMed PubMed Citation Articles by Buijsrogge, M. P. Articles by Borst, C. Related Collections Cardiac - physiology Coronary disease Minimally invasive surgery

J Thorac Cardiovasc Surg 2002;123:341-347
© 2002 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease (ACD)

Unconventional vessel wall apposition in off-pump porcine coronary artery bypass grafting: Low versus high graft flow

From the Heart Lung Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands.

Received for publication May 8, 2001. Revisions requested June 22, 2001; revisions received July 18, 2001. Accepted for publication Aug 2, 2001. Address for reprints: Cornelius Borst, MD, PhD, Professor of Experimental Cardiology, University Medical Center Utrecht (Room G02.523), Heart Lung Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands (E-mail: c.borst{at}hli.azu.nl).

Objective: Facilitated coronary anastomosis techniques may involve unconventional vessel wall apposition in contrast to standard intima-intima apposition. We assessed the patency, anastomotic thrombus formation, and intimal hyperplasia of unconventional intima-adventitia apposition versus conventional suturing techniques in beating heart coronary bypass grafting under low versus high graft flow conditions.
Methods: The intima-adventitia (n = 28) and conventional anastomoses (n = 28) were evaluated intraoperatively (n = 56), at 4 hours (n = 20), and at 5 weeks (n = 36) in a new off-pump low-flow (n = 28) and high-flow (n = 28) porcine bypass model (15 mL/min and about 60 mL/min, respectively). The anastomoses were assigned to the animals by means of randomized stratification and examined by means of flow measurements, angiography, and histology.
Results: Mean graft flows in intima-adventitia and in conventional anastomoses were similar (P = .709). All but 1 of 56 anastomoses (low flow conventional) were fully patent at the time of death. At 4 hours, only small platelet depositions were found at the exposed media and adventitia in the unconventional anastomoses. At 5 weeks, little streamlining intimal hyperplasia was found, which was comparable between the anastomoses (P = .600).
Conclusions: In low-flow conditions (15 mL/min) unconventional intima-adventitia apposition was not detrimental to the internal thoracic–coronary artery anastomosis in the pig. This finding may expand design strategies of facilitated coronary artery bypass anastomosis techniques.

This article has been cited by other articles:

				W. J. L. Suyker, M. P. Buijsrogge, P. T. W. Suyker, C. W. J. Verlaan, C. Borst, and P. F. Grundeman Stapled coronary anastomosis with minimal intraluminal artifact: The S2 Anastomotic System in the off-pump porcine model J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 498 - 503. [Abstract] [Full Text] [PDF]

				J. S. Scheltes, C. J. van Andel, P. V. Pistecky, and C. Borst Coronary anastomotic devices: blood-exposed non-intimal surface and coronary wall stress J. Thorac. Cardiovasc. Surg., July 1, 2003; 126(1): 191 - 199. [Abstract] [Full Text] [PDF]

				M. P. Buijsrogge, C. W. J. Verlaan, P. F. Grundeman, and C. Borst Briefly occlusive coronary anastomosis with tissue adhesive J. Thorac. Cardiovasc. Surg., February 1, 2003; 125(2): 385 - 390. [Abstract] [Full Text] [PDF]

				M. P. Buijsrogge, J. S. Scheltes, M. Heikens, P. F. Grundeman, P. V. Pistecky, and C. Borst Sutureless coronary anastomosis with an anastomotic device and tissue adhesive in off-pump porcine coronary bypass grafting J. Thorac. Cardiovasc. Surg., April 1, 2002; 123(4): 788 - 794. [Abstract] [Full Text] [PDF]