HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Robin H. Heijmen Cornelius Borst Paul F. Gründeman Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Heijmen, R. H. Articles by Verlaan, C. W.J. Search for Related Content PubMed PubMed Citation Articles by Heijmen, R. H. Articles by Verlaan, C. W.J.

Ann Thorac Surg 1998;65:1093-1099
© 1998 The Society of Thoracic Surgeons

Temporary Luminal Arteriotomy Seal for Bypass Grafting

^a Heart Lung Institute, Department of Cardiology, Utrecht University Hospital, Utrecht, the Netherlands

Accepted for publication December 2, 1997.

Address reprint requests to Dr Borst, Department of Cardiology, Heart Lung Institute, Utrecht University Hospital, Rm G02.523, PO Box 85500, 3508 GA Utrecht, the Netherlands
e-mail: (exp.cardio{at}hli.azu.nl)

Presented at the Seventieth Scientific Sessions of the American Heart Association, Orlando, FL, Nov 9–12, 1997.

Background. To enable off-pump coronary operations in a bloodless surgical field without ischemic complications, we developed and assessed a temporary luminal arteriotomy seal in a porcine carotid artery bypass graft model.

Methods. In 16 consecutive pigs (25 kg, 32 anastomoses) the arteriotomy was sealed luminally by a polyurethane elliptic convex seal. Endothelial denudation, medial necrosis, and intimal hyperplasia were measured quantitatively and compared with those seen in conventionally sutured anastomoses.

Results. The median occlusive time upon insertion or retrieval was 90 and 82 seconds, including the arteriotomy and securing the anastomosis, respectively. Once properly positioned, the seal provided a bloodless arteriotomy in all anastomoses. Microsurgical suturing was performed without leakage of the seal and with unimpeded flow. In the recipient artery, endothelial denudation was limited to one third of its circumference. No medial necrosis was found. Intimal hyperplasia at heel and toe was not significantly different from that seen in conventionally sutured anastomoses.

Conclusions. During end-to-side bypass grafting, the temporary luminal arteriotomy seal provided a bloodless surgical field without interfering with recipient artery blood flow and with minimal damage to the arterial wall.

This article has been cited by other articles:

				I. S. Gill, L. A. Higginson, G. S. Maharajh, and W. J. Keon Early and follow-up angiography in minimally invasive coronary bypass without mechanical stabilization Ann. Thorac. Surg., January 1, 2000; 69(1): 56 - 60. [Abstract] [Full Text] [PDF]

				E. E.H.L. van Aarnhem, A. P. Nierich, and E. W.L. Jansen When and how to shunt the coronary circulation in off-pump coronary artery bypass grafting Eur. J. Cardiothorac. Surg., November 1, 1999; 16(suppl_2): S2 - S6. [Abstract] [Full Text] [PDF]

				R. H. Heijmen, C. Borst, C. M. Moues, Y. J.M. van der Helm, P. F. Grundeman, and G. Pasterkamp Temporary luminal arteriotomy seal: III. Postmortem arteriosclerotic human coronary artery Ann. Thorac. Surg., January 1, 1999; 67(1): 120 - 123. [Abstract] [Full Text] [PDF]

				R. H. Heijmen, C. Borst, R. van Dalen, C. W.J. Verlaan, C. M. Moues, Y. J.M. van der Helm, and P. F. Grundeman Temporary luminal arteriotomy seal: II. coronary artery bypass grafting on the beating heart Ann. Thorac. Surg., August 1, 1998; 66(2): 471 - 476. [Abstract] [Full Text] [PDF]