Noda H, Katoh T, Ikenaga S, Ikeda Y, Gohra H, Hamano K, Sugi K, Zempo N, Fujimura Y, Esato K
First Department of Surgery, Yamaguchi University, School of Medicine, Ube, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Nov;46(11):1133-6. doi: 10.1007/BF03217888.
The experiment was intended to test the feasibility of VCS clips for coronary anastomosis during minimally invasive direct coronary artery bypass grafting (MIDCAB). Six dogs were anesthetized under endotracheal intubation and were placed on right lateral position. Three 10.5-mm ports were placed on the left lateral chest wall (3rd, 5th and 7th intercostal space) and the left internal thoracic artery (LITA) was dissected completely from its root to bifurcation under thoracoscope. Chest was opened through the left 6th intercostal space. The anastomotic site of LAD was dissected and was then occluded temporally for 5 minutes to obtain ischemic preconditioning. The anastomosis was performed by the following procedure; horizontal mattress sutures of 8-0 polypropylene were placed on heel, toe and the center of both lateral sides. Two VCS clips (8 in total), 0.9-mm in size, were applied between every two sutures. After the measurement of graft flow, the pedicle was transected and an angiography was done. Graft flow was 12-17 ml/min (mean 14.7 +/- 2.1 ml/min) and cineangiogram showed good patency of LITA and no anastomotic stenosis. VCS clips were supposed to have a potential for facilitating port access coronary artery bypass grafting.
该实验旨在测试VCS夹在微创直接冠状动脉旁路移植术（MIDCAB）中用于冠状动脉吻合的可行性。6只狗经气管插管麻醉后置于右侧卧位。在左侧胸壁（第3、5和7肋间间隙）放置3个10.5毫米的端口，在胸腔镜下将左胸廓内动脉（LITA）从其根部至分叉处完全游离。经左侧第6肋间间隙打开胸腔。解剖左前降支（LAD）的吻合部位，然后暂时阻断5分钟以获得缺血预处理。按以下步骤进行吻合；用8-0聚丙烯线在足跟、趾端及两侧中央放置水平褥式缝线。每两根缝线之间应用两个VCS夹（共8个），尺寸为0.9毫米。测量移植血管血流后，切断蒂部并进行血管造影。移植血管血流为12-17毫升/分钟（平均14.7±2.1毫升/分钟），电影血管造影显示LITA通畅良好且无吻合口狭窄。VCS夹被认为有促进端口入路冠状动脉旁路移植术的潜力。
