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Ann Thorac Surg 1998;66:1041-1044
© 1998 The Society of Thoracic Surgeons

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Supplement

Facilitated vascular anastomoses: the one-shot device¹

^a Department of Thoracic and Cardiovascular Surgery, Centre Cardiologique du Nord, St. Denis, France
^b Section of Neurosurgery, Loma Linda University Medical Center, Loma Linda, California, USA

Address reprint requests to Dr Kirsch, Section of Neurosurgery, Loma Linda University Medical Center, 11234 Anderson St, Loma Linda, CA 92354

Presented at "Facts and Myths of Minimally Invasive Cardiac Surgery: Current Trends in Thoracic Surgery IV," New Orleans, LA, Jan 24, 1998.

Abstract

Background. A mechanical system for facilitating vascular anastomosis (end-to-side, end-to-end) is described that enables the rapid construction of nonpenetrated, compliant junctions. The instrument (United States Surgical One-Shot system) simultaneously applies either 10 or 12 nonpenetrating, arcuate-legged titanium clips to everted vessel or prosthetic conduit edges.

Methods and Results. The instrument has been tested in animals (jugular and femoral vein jump grafts in carotid and femoral arteries, interpositional grafts, 20 pigs) and human cadaveric constructs (saphenous veins to left anterior descending coronary arteries, 20 cases, 5 brachiocephalic access fistulas) as end-to-side constructs. Clipped constructs have equivalent or superior physical properties to control sutured constructs (6-0 polypropylene) as gauged by burst and tensile strength. All studies were performed under Food and Drug Administration Good Laboratory Practice standards, and the device has been approved for marketing by the Food and Drug Administration.

Conclusions. The device enables rapid and reproducible vascular anastomotic constructs with vessels as small as 1.8 mm outer diameter. The constructs are flanged, interrupted, and nonpenetrated.

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