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Ann Thorac Surg 2006;82:1452-1456
© 2006 The Society of Thoracic Surgeons

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Original Articles: Cardiovascular

Mid-Term Patency After Magnetic Coupling for Distal Bypass Anastomosis in Coronary Surgery

^a Department of Cardiac Surgery, Grosshadern Medical Centre, Ludwig-Maximilians-University München, München, Germany
^b Department of Internal Medicine I, Grosshadern Medical Centre, Ludwig-Maximilians-University München, München, Germany

Accepted for publication April 27, 2006.

^_* Address correspondence to Prof Dr Calin Vicol, Herzchirurgische Klinik und Poliklinik, Klinikum Grosshadern der LMU München, Marchioninistr. 15, 81377 München, Germany (Email: calin.vicol{at}med.uni-muenchen.de).

BACKGROUND: The magnetic vascular positioner (MVP), a device for distal bypass anastomosis in coronary surgery, was developed to allow a simple and rapid procedure and to improve graft patency. We analyze our mid-term results with this device.

METHODS: Eighteen distal anastomoses were performed by using the MVP, and 18 with a hand-sewn technique were completed in 11 patients. The target arteries for the MVP anastomosis were the left anterior descending in 9 patients, a marginal branch in 4, a diagonal branch in 3, and right coronary artery in 2. The left internal thoracic artery was used as graft in 9 patients, saphenous vein in 6, right internal thoracic artery in 2, and radial artery in 1.

RESULTS: Coronary angiography was performed at discharge and after a complete follow-up of 19 ± 3.5 months. Patency at follow-up was 83.3% (15/18) for MVP anastomoses and 100% (18/18) for hand-sewn anastomoses. All occluded MVP anastomoses were performed with small-size devices. In one patient, a high-grade left main stenosis was overestimated. Competitive flow may be suspected in this case as a cause of graft occlusion. No deaths occurred during hospital stay or during follow-up. Freedom from reintervention was 100%.

CONCLUSIONS: The MVP is the only mechanical connector for distal anastomoses applicable for all kind of grafts, for all coronary artery locations, and with both end-to-side and side-to-side technique. Mid-term patency of MVP anastomoses is acceptable but inferior to the patency of hand-sewn anastomoses. Occlusion of MVP supplied grafts may be produced by small device size.

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Invited commentary

Randall Kevin Wolf
Ann. Thorac. Surg. 2006 82: 1456-1457. [Extract] [Full Text] [PDF]

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				W. J.L. Suyker and C. Borst Coronary Connector Devices: Analysis of 1,469 Anastomoses in 1,216 Patients Ann. Thorac. Surg., May 1, 2008; 85(5): 1828 - 1836. [Abstract] [Full Text] [PDF]

				R. K. Wolf Invited commentary. Ann. Thorac. Surg., October 1, 2006; 82(4): 1456 - 1457. [Full Text] [PDF]