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Ann Thorac Surg 2002;73:1451-1456
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

Coronary end-to-side sleeve anastomosis using adhesive in off-pump bypass grafting in the pig

Marc P. Buijsrogge, MDa, Cees W.J. Verlaana, Mattie H.P. van Rijen, BSa, Paul F. Gründeman, MD, PhD*a, Cornelius Borst, MD, PhDa

a Heart Lung Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands

Accepted for publication January 11, 2002.

* Address reprint requests to Dr. Gründeman, Experimental Cardiology Laboratory, University Medical Center Utrecht (Room G02.523), Heart Lung Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
e-mail: exp.cardio{at}hli.azu.nl

Background. In the exploration of facilitated coronary anastomosis strategies, we assessed a new octyl-cyanoacrylate adhesive in combination with a modified end-to-side sleeve anastomosis in off-pump bypass grafting in the pig.

Methods. Sleeve-adhesive anastomoses (n = 20) were evaluated intraoperatively, at 3 days (n = 4), and at 5 weeks (n = 16) in an off-pump, low (<=15 mL/min; n = 10) and high flow (approximately 60 mL/min; n = 10) porcine bypass model. All anastomoses were examined by flow measurement, angiography, and histology.

Results. Anastomosis construction took 8.5 minutes (6.7 to 10.2 minutes; median [15th to 85th percentile]). At 5 weeks, all anastomoses were fully patent (FitzGibbon grade A). The adhesive did not cause impaired vessel wall healing, but was surrounded by a focal acute and limited chronic (foreign body giant cells occasionally seen) inflammatory reaction at the adventitial application site.

Conclusions. Octyl-cyanoacrylate tissue adhesive combined with end-to-side internal mammary to coronary artery sleeve anastomosis construction proved to be feasible, even in low bypass graft flow conditions (<=15 mL/min; prothrombotic milieu) in the pig and deserves interest in exploration of facilitated anastomosis strategies in coronary artery bypass grafting.




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