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J Thorac Cardiovasc Surg 2009;138:775-777
© 2009 The American Association for Thoracic Surgery

Brief Technique Report

Biologic anastomosis: The first case of biologic coronary bypass surgery

Masashi Komeda, MD, PhDa,b,*, Akira Marui, MD, PhDa,*,*, Keiichi Tambara, MD, PhDa, Masaya Yamamoto, PhDc, Yoshiaki Saji, MDa, Takeshi Nishina, MD, PhDa, Yasuhiko Tabata, PhD, DMSc, DPharmc

a Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
b Department of Cardiovascular Surgery, Nagoya Heart Center, Aichi, Japan
c Department of Biomaterials, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan

Received for publication May 13, 2008; accepted for publication May 26, 2008.

* Address for reprints: Akira Marui, MD, PhD, Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara, Sakyo, Kyoto, 606-8507 Japan. (Email: marui@kuhp.kyoto-u.ac.jp).

The first 20% of the full text of this article appears below.


   Introduction
 
In spite of advances in the treatment of ischemic heart disease, there exist patients who are not eligible for current revascularization procedures because of diffuse coronary lesions or too-small vessel caliber. To offer a more effective therapeutic option for these patients, we developed biologic coronary artery bypass grafting (Bio-CABG), which uses sustained release of basic fibroblast growth factor (bFGF) and an omental flap as a connector between the right gastroepiploic artery (RGEA) and ungraftable coronary arteries.1,2Go Here we report the first clinical case of Bio-CABG.


   Clinical Summary
 
We used gelatin hydrogel sheets as a sustained release carrier for bFGF.3Go bFGF and the gelatin hydrogel sheet were prepared as previously described.4Go An aqueous solution of bFGF (250 µg/3 mL) was applied to freeze-dried gelatin hydrogel sheets (15 x 10 cm) and then left at an ambient temperature for 1 hour to incorporate bFGF into each gelatin hydrogel sheet. The sheet slowly released bFGF for approximately 3 weeks.

Bio-CABG was performed as follows. Through an upper–median laparotomy, the stomach and omentum were exposed, and arterial branches from the RGEA to the stomach were ligated and severed from the pylorus along the greater curvature of the stomach to the end of the RGEA. Arterial branches from the RGEA to . . . [Full Text of this Article]






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