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Ann Thorac Surg 2004;78:722-724
© 2004 The Society of Thoracic Surgeons

How to do it

Interrupted distal anastomosis: the interrupted "porcupine" technique

Baron L. Hamman, MDa*, Cory H. White, BSa

a Baylor University Medical Center, Clinical Cardiology Research Center, Dallas, Texas, USA

Accepted for publication November 20, 2003.

* Address reprint requests to Dr Hamman, 3600 Gaston Ave, Barnett Tower 1202, Dallas, TX 75246, USA
e-mail: bhamman{at}heartplace.com

The distal coronary artery bypass graft anastomosis created by an interrupted technique using nitinol clips is likely superior to that created with continuous suture because surgeons place clips with optimal visualization, and the anastomosis exhibits optimal compliance and cannot become a "purse-string" once constructed. Skillful use of the clips allows the surgeon to work in the ever more cramped quarters of the minithoracotomy or minimally invasive incision. Anastomosing vessels without knot tying is a valuable practice in the application of remote and robotic surgeries.






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