Buijsrogge Marc P, Verlaan Cees W J, van Rijen Mattie H P, Gründeman Paul F, Borst Cornelius
Heart Lung Center Utrecht, University Medical Center Utrecht, The Netherlands.
Ann Thorac Surg. 2002 May;73(5):1451-6. doi: 10.1016/s0003-4975(02)03423-9.
In the exploration of facilitated coronary anastomosis strategies, we assessed a new octylcyanoacrylate adhesive in combination with a modified end-to-side sleeve anastomosis in off-pump bypass grafting in the pig.
Sleeve-adhesive anastomoses (n = 20) were evaluated intraoperatively, at 3 days (n = 4), and at 5 weeks (n = 16) in an off-pump, low (< or = 15 mL/min; n = 10) and high flow (approximately 60 mL/min; n = 10) porcine bypass model. All anastomoses were examined by flow measurement, angiography, and histology.
Anastomosis construction took 8.5 minutes (6.7 to 10.2 minutes; median [15th to 85th percentile]). At 5 weeks, all anastomoses were fully patent (FitzGibbon grade A). The adhesive did not cause impaired vessel wall healing, but was surrounded by a focal acute and limited chronic (foreign body giant cells occasionally seen) inflammatory reaction at the adventitial application site.
Octyl-cyanoacrylate tissue adhesive combined with end-to-side internal mammary to coronary artery sleeve anastomosis construction proved to be feasible, even in low bypass graft flow conditions (< or = 15 mL/min; prothrombotic milieu) in the pig and deserves interest in exploration of facilitated anastomosis strategies in coronary artery bypass grafting.
在探索简便的冠状动脉吻合策略时，我们评估了一种新型氰基丙烯酸辛酯粘合剂与改良的端侧套入式吻合术相结合，用于猪的非体外循环搭桥手术。
在非体外循环、低流量（≤15毫升/分钟；n = 10）和高流量（约60毫升/分钟；n = 10）的猪搭桥模型中，术中、术后3天（n = 4）和5周（n = 16）评估套入 - 粘合剂吻合术（n = 20）。所有吻合口均通过流量测量、血管造影和组织学检查。
吻合口构建耗时8.5分钟（6.7至10.2分钟；中位数[第15至85百分位数]）。在5周时，所有吻合口均完全通畅（菲茨吉本分级为A级）。粘合剂未导致血管壁愈合受损，但在应用部位的外膜处被局部急性和局限性慢性（偶尔可见异物巨细胞）炎症反应包围。
氰基丙烯酸辛酯组织粘合剂与乳内动脉至冠状动脉端侧套入式吻合术相结合，即使在猪的低搭桥流量条件下（≤15毫升/分钟；血栓形成环境）也被证明是可行的，值得在冠状动脉搭桥术中探索简便的吻合策略时关注。
