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J Thorac Cardiovasc Surg 2003;126:177-178
© 2003 The American Association for Thoracic Surgery

Cardiopulmonary support and physiology

Discussion

Dr Erik W. Jansen (Utrecht, Netherlands). This is an interesting multicenter trial on an innovative coronary artery, actually a general vascular, anastomosis technique. On average, 11.8 self-closing clips were used to create the LITA-to-LAD anastomosis, requiring a mean anastomosis time of 10 minutes and a minimum of 3 minutes. Most were done on OPCAB. So this is really a smooth procedure. That is very good. There were only two conversions, no reoperations for bleeding. What was the rate of extra sutures or clips for hemostasis?

The quality of the anastomosis is well studied by use of the current standards of FitzGibbon, TIMI, and POEM in angiography in 77% of patients. The 6-month patency rate as a standard is good, 94% FitzGibbon grade A, and a favorable percent diameter stenosis. This compares with the patency in all recent off-pump trials.

There is little intravascular nitinol, thus low thrombogenicity. Did the patients receive any antithrombotic medication?

The technique looks very attractive and simple. Basically, it is a . . . [Full Text of this Article]