JTCS Email Content Delivery
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Jens Wippermann
Martin Breuer
Thorsten Wahlers
Johannes M. Albes
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wippermann, J.
Right arrow Articles by Albes, J. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wippermann, J.
Right arrow Articles by Albes, J. M.
Related Collections
Right arrow Cardiac - other
Right arrow Minimally invasive surgery

J Thorac Cardiovasc Surg 2006;132:325-331
© 2006 The American Association for Thoracic Surgery

Evolving Technology

Long-term effects in distal coronary anastomoses using different adhesives in a porcine off-pump model

Jens Wippermann, MD a , * , Christo Konstas b , Martin Breuer, MD b , Hartwig Kosmehl, MD, PhD c , Thorsten Wahlers, MD, PhD a , Johannes M. Albes, MD, PhD d

a Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
b Cardiothoracic and Vascular Surgery, University Hospital Jena, Jena, Germany
c Institute of Pathology, Helios Clinic, Erfurt, Erfurt, Germany
d Heart Center Brandenburg, Bernau, Bernau, Germany

Received for publication November 10, 2005; revisions received January 24, 2006; accepted for publication February 20, 2006.

* Address for reprints: Jens Wippermann, MD, Department of Cardiothoracic Surgery, University Hospital Cologne, Kerpener Strasse 62, 50937 Cologne, Germany (Email: jens.wippermann{at}uk-koeln.de).

OBJECTIVE: Adhesives are useful supplements to seal distal coronary anastomoses, particularly in patients who receive less-invasive coupling techniques. Information regarding long-term structural effects after application, however, is limited. The purpose of this large animal study was to examine the effects of 3 different commercially available surgical adhesives.

METHODS: Twelve end-to-side anastomoses were created between the left internal thoracic artery and the left anterior descending coronary artery in a porcine beating heart model. Three different adhesives were applied externally and circumferentially to the anastomosis site. In group I (n = 4) gelatin-resorcinol-formaldehyde glue (Cardial, Technopole, Sainte-Etienne, France), in group II (n = 4) n-butyl-2-cyanoacrylate glue, and in group III (n = 4) albumin-glutaraldehyde glue were used. All anastomoses were examined intraoperatively by flow measurement. After 3 months the anastomoses were reassessed for patency and the vessels were evaluated histologically.

RESULTS: By means of 4 stay sutures and subsequent glue application, anastomoses could be created successfully on the first attempt in all animals. Perioperative flow through the left internal thoracic artery was similar in all groups. In 4 animals an additional suture was placed to control bleeding. After 3 months, the patency rate was 83.3% (10/12). In group I all anastomoses were patent whereas in both groups II and III one anastomosis was occluded. None of the adhesives caused impaired vessel wall healing but they did demonstrate moderate-to-dense adhesions to the surrounding tissue. On histologic examination, gelantin-resorcinol-formaldehyde glue exhibited minimal tissue reaction (foreign-body granuloma) whereas n-butyl-2-cyanoacrylate glue showed moderate reaction. In contrast, albumin-glutaraldehyde glue caused severe inflammatory reaction with extensive fibroblastic proliferation.

CONCLUSION: Construction of an end-to-side internal thoracic artery–coronary artery sleeve anastomosis using adhesives was feasible in the pig. Among the tissue adhesives used in this study, gelantin-resorcinol-formaldehyde glue appeared to be superior to cyanoacrylate and albumin-glutaraldehyde glue. The latter one, however, caused severe adverse histologic effects and thus cannot be recommended for bonding coronary anastomoses.

Abbreviations and Acronyms AG = albumin-glutaraldehyde; CYAC = n-butyl-2-cyanoacrylate; GRF = gelatin-resorcinol-formaldehyde; ITA = internal thoracic artery; LAD = left anterior descending coronary artery; LITA = left internal thoracic artery




This article has been cited by other articles:


Home page
 J. Thorac. Cardiovasc. Surg.Home page
W. Schiller, H. Rudorf, C. B. Welzel, M. J. Kiderlen, C. Probst, O. Dewald, and A. Welz
Sutureless anastomoses of rabbit carotid arteries with BioGlue.
J. Thorac. Cardiovasc. Surg., December 1, 2007; 134(6): 1513 - 1518.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2006 by The American Association for Thoracic Surgery.