Nazari Stefano
Fondazione Alexis Carrel, Via Marconi, Res Parco 152, 20080, Basiglio, MI, Italy.
Interact Cardiovasc Thorac Surg. 2010 Feb;10(2):161-4. doi: 10.1510/icvts.2009.216291. Epub 2009 Nov 20.
In past years, we developed expandable devices (type I and II) for sutureless aortic anastomosis. We have now further modified the device (type III) incorporating a second expandable ring, external to the main one, which can be operated contrariwise in such a way that the aortic wall (i.e. the dissection layers) is compressed between the two expandable rings, providing full control on both the layers compression pressure and the anastomosis final diameter. The device was evaluated in ex vivo experimental models of swine aortic arch fresh samples; air-tight sealing at increasing endovascular pressures was also evaluated and compared with sealing achieved by standard suturing. Ex vivo data suggest that the present version of the device can be used easily and quickly also in elliptical, asymmetric 'oblique' anastomosis as when concavity arch is involved. Perfect air-tight sealing of the anastomosis was verified at endovascular pressures up to 150 mmHg, while standard suture cannot withstand even minimal endovascular air pressure. Compared to the previous versions, the present device is less bulky and softer, can be used also for concavity arch resection and provides full and standardizable control on dissection layers stable and sealed approximation.
在过去几年中，我们研发了用于无缝合主动脉吻合术的可扩张装置（I型和II型）。现在，我们对该装置（III型）进行了进一步改进，增加了一个位于主扩张环外部的第二扩张环，该第二扩张环的操作方式相反，能使主动脉壁（即解剖层面）被夹在两个扩张环之间，从而全面控制两层的压缩压力以及吻合口的最终直径。该装置在猪主动脉弓新鲜样本的体外实验模型中进行了评估；还评估了在不断增加的血管内压力下的气密密封情况，并与标准缝合实现的密封效果进行了比较。体外数据表明，该装置的当前版本在涉及弓凹面等椭圆形、不对称“斜形”吻合术中也能轻松快速使用。在高达150 mmHg的血管内压力下，吻合口的完美气密密封得到了验证，而标准缝合甚至无法承受最小的血管内空气压力。与之前的版本相比，当前装置体积更小、更柔软，还可用于弓凹面切除，并能对解剖层面的稳定和密封接近度进行全面且标准化的控制。
