Itoda Yoshifumi, Panthee Nirmal, Tanaka Tsuruhito, Ando Takehiro, Sakuma Ichiro, Ono Minoru
Department of Cardiac Surgery, University of Tokyo, Tokyo, Japan.
Faculty of Engineering, University of Tokyo, Tokyo, Japan.
Ann Thorac Surg. 2016 Feb;101(2):736-41. doi: 10.1016/j.athoracsur.2015.09.082.
We evaluated the safety and feasibility of a new anastomotic device that simplifies coronary distal anastomosis during minimally invasive and robotically assisted coronary artery bypass graft surgery (CABG).
Fourteen miniature pigs underwent off-pump CABG using bilateral internal thoracic arteries (ITA), namely, left ITA to left anterior descending artery and right ITA to right coronary artery. The device was used for distal anastomosis in a device group (n = 11), and conventional 7-0 polypropylene suture in a control group (n = 3). Graft flow was measured intraoperatively. One-month, 3-month, and 6-month postoperative angiography evaluations were done. Histopathologic examination of the anastomosis was also done.
Baseline and intraoperative characteristics were similar in the two groups. There was no difference of anastomotic time between groups (p = 0.59). Graft flows were also similar (p = 0.55), with good diastolic pattern in both groups. Angiography demonstrated FitzGibbon A patency in all anastomoses of both groups at each evaluation period. Histopathologic examination showed nonspecific inflammatory changes in the device group.
The safety and feasibility of this anastomotic device for distal coronary anastomosis were shown in the swine model.
我们评估了一种新型吻合装置在微创和机器人辅助冠状动脉旁路移植术（CABG）中简化冠状动脉远端吻合的安全性和可行性。
14只小型猪接受了非体外循环CABG，使用双侧胸廓内动脉（ITA），即左ITA至左前降支动脉和右ITA至右冠状动脉。在器械组（n = 11）中使用该装置进行远端吻合，在对照组（n = 3）中使用传统的7-0聚丙烯缝线。术中测量移植血管血流量。术后1个月、3个月和6个月进行血管造影评估。还对吻合口进行了组织病理学检查。
两组的基线和术中特征相似。两组之间的吻合时间无差异（p = 0.59）。移植血管血流量也相似（p = 0.55），两组均具有良好的舒张模式。血管造影显示在每个评估期两组所有吻合口均为菲茨吉本A通畅。组织病理学检查显示器械组有非特异性炎症改变。
在猪模型中显示了这种冠状动脉远端吻合装置的安全性和可行性。
