Bar-El Yaron, Tio Fermin O, Shofti Rona
Department of Cardiac Surgery, Rambam Medical Center, Israel Institute of Technology, Haifa, Israel.
Heart Surg Forum. 2003;6(5):369-74.
The efficacy and long-term patency of a new distal anastomotic device (DAD) for the creation of rapid, sutureless end-to-side venous or arterial coronary artery bypass graft anastomoses were tested in a sheep model.
The DAD was used on the beating hearts of 34 sheep to create 20 anastomoses between saphenous veins (n = 9) or internal mammary arteries (n = 11) and various coronary arteries. Fourteen conventional hand-sutured anastomoses (7 veins; 7 internal mammary arteries) served as controls. The sheep were sacrificed 1 day, 1 week, and 1, 3, and 6 months after surgery.
The immediate patencies of all anastomoses were proven by the rates and pattern of flow. There were no significant differences between the DAD and suture anastomosis groups in presacrifice pulsatility index and occlusion rate. The histomorphometric studies showed complete intimal bridging over the DAD with no significant differences between DAD and suture anastomoses with respect to tissue response, mural injury, inflammation, and adventitial fibrosis.
The DAD enables the creation of rapid, efficient, and sutureless venous or arterial coronary anastomoses. The long-term results of histomorphometric studies show that the results with the DAD are comparable with those of conventional hand-sutured anastomoses.
在绵羊模型中测试了一种新型远端吻合装置(DAD)用于快速、无缝合的端侧静脉或动脉冠状动脉旁路移植吻合术的疗效和长期通畅性。
在34只绵羊的跳动心脏上使用DAD,在大隐静脉(n = 9)或乳内动脉(n = 11)与各种冠状动脉之间进行20次吻合。14次传统手工缝合吻合术(7条静脉;7条乳内动脉)作为对照。术后1天、1周、1个月、3个月和6个月处死绵羊。
通过血流速度和模式证明所有吻合口的即时通畅性。在处死前的搏动指数和闭塞率方面,DAD组和缝合吻合组之间无显著差异。组织形态计量学研究显示DAD上有完整的内膜桥接,在组织反应、壁损伤、炎症和外膜纤维化方面,DAD和缝合吻合之间无显著差异。
DAD能够实现快速、高效且无缝合的静脉或动脉冠状动脉吻合。组织形态计量学研究的长期结果表明,DAD的结果与传统手工缝合吻合术的结果相当。