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Ann Thorac Surg 2000;70:1384-1388
© 2000 The Society of Thoracic Surgeons

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Original articles: cardiovascular

Arteriotomy closure by glued patch in the porcine carotid artery

^a Department of Cardiology, Heart Lung Institute, Utrecht University Medical Center, Utrecht, The Netherlands

Address reprint requests to Dr Borst, Experimental Cardiology, Utrecht University Hospital (Room G02.523), PO Box 85500, 3508 GA Utrecht, The Netherlands
e-mail: exp.cardio{at}hli.azu.nl

Background. A thoracoscopic approach to coronary bypass grafting warrants renewed search for facilitated vascular anastomosis methods. We reassessed tissue adhesion, sealing properties, and histotoxicity of iso-butyl-cyanoacrylate, in a simplified anastomosis model.

Methods. In 12 Dutch landrace pigs, five arteriotomies were made in each carotid artery. The arteriotomies were closed by conventional microvascular suturing or by pericardial patch (Peri-Strips) and iso-butyl-cyanoacrylate. The animals were sacrificed at 2 hours (n = 2), 2 days (n = 5), and 4 weeks (n = 5). The arteries were examined by flow measurement, angiography, and histologic analysis.

Results. The time required to close arteriotomies by conventional suturing was 257 ± 43 seconds (mean ± SD) and by glued patch 51 ± 27 seconds (p < 0.001). In all arteriotomies covered by glued patch, complete hemostasis was obtained. At 2 days and 4 weeks, with both methods the same histologic results were observed. At follow-up, all carotid arteries were patent without stenoses.

Conclusions. Arteriotomy closure by glued patch was simple, fast, reliable, and without signs of histotoxicity. Adhesives deserve to be reconsidered as an alternative to suturing in closed chest beating-heart coronary surgery.

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