Six-Month Healing of the Nonocclusive Coronary Anastomotic Connector in an Off-Pump Porcine Bypass Model

2014 ◽  
Vol 9 (2) ◽  
pp. 130-136 ◽  
Author(s):  
David Stecher ◽  
Pierfrancesco Agostoni ◽  
Gerard Pasterkamp ◽  
Imo E. Hoefer ◽  
Lex A. van Herwerden ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Optical Coherence Tomography ◽  
Coronary Artery ◽  
Pilot Study ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Optical Coherence ◽  
Off Pump ◽  
Scanning Electron

Objective This pilot study evaluates the anastomotic healing of the Excimer Laser Assisted Nonocclusive Anastomosis coronary connector at 6 months in a porcine off-pump coronary artery bypass (OPCAB) model. Methods Left internal thoracic artery to left anterior descending coronary artery bypass in two animals and left internal thoracic artery to left anterior descending coronary artery and right internal thoracic artery to right coronary artery bypasses in one animal were evaluated intraoperatively and at 6 months. The anastomoses (n = 4) were examined by angiography, intravascular ultrasound, optical coherence tomography, scanning electron microscopy, and histology. Results At follow-up, all anastomoses (n = 4) were fully patent (FitzGibbon grade A). Scanning electron microscopy demonstrated complete endothelial coverage of the anastomotic surface, and histology showed minimal streamlining intimal hyperplasia. The in vivo intravascular ultrasound and optical coherence tomography acquisitions confirmed histologic findings. Optical coherence tomography demonstrated 0.06-mm intimal coverage of the intraluminal part of the connector along the full circumference of the anastomosis. Conclusions In this pilot study, the Excimer Laser Assisted Non-occlusive Anastomosis coronary connector showed an excellent healing response on the long-term in the porcine OPCAB model. Hence, this new concept might be a potential alternative to hand-sutured anastomosis in (minimally invasive) OPCAB surgery.

Comparison of scanning electron microscopy and optical coherence tomography for imaging of coronary bifurcation stents

2015 ◽  
Vol 85 (7) ◽  
pp. 1141-1149 ◽  
Author(s):  
Guilherme V. Silva ◽  
Amir Gahremanpour ◽  
Guilherme F. Attizzani ◽  
Yi Zeng ◽  
Wei Wang ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Optical Coherence Tomography ◽  
Optical Coherence ◽  
Coronary Bifurcation ◽  
Scanning Electron

Exclusive Bilateral Internal Thoracic Artery Grafts for Myocardial Revascularization Requiring Four Anastomoses or More: Outcomes from a Single Center Experience

2016 ◽  
Vol 65 (04) ◽  
pp. 265-271
Author(s):  
Andrea Perrotti ◽  
Enrica Dorigo ◽  
Camille Durst ◽  
Djamel Kaili ◽  
Sidney Chocron ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Univariate Analysis ◽  
Bypass Graft ◽  
Myocardial Revascularization ◽  
Wound Complication ◽  
Safe Procedure ◽  
Off Pump

Introduction Multivessel coronary artery bypass graft (CABG) with bilateral internal thoracic arteries (BITA) has only been uncommon and technically demanding. We describe our experience with BITA only CABGs requiring ≥ 4 anastomoses. Material and Methods The department's database was queried for patients undergoing isolated CABG with ≥ 4 anastomoses. The surgical technique included systematically a right internal thoracic artery (ITA) of left ITA Y graft. The multivariate model included variables with a p < 0.3 at univariate analysis. Results Between January 2006 and December 2009, 251 consecutive patients (71 ± 10 years) (on-pump: 130, off-pump: 121) had CABG with ≥ 4 anastomoses, representing 21% of total isolated CABGs for the same period; all patients received a totally arterial BITA only revascularization. Follow-up was 4.9 ± 1.6 years. Overall and cardiac cumulative survivals were 78 and 92%, respectively, at 5 years. The occurrence of any major postoperative complication was associated with overall and cardiac mortality (odds ratio [OR]: 3.6, 95% confidence interval [CI]: 1.3–9.9 and OR: 5.4, 95% CI: 1.3–21.9, respectively). Major sternal wound complication requiring surgical revision was not associated with impaired glucose control (n = 9; diabetics: 6/82, 7.3%; nondiabetics: 3/169, 1.8%, p = 0.06). Preoperative kidney failure was associated with incomplete revascularization (OR: 6.2; 95% CI: 1.2–33.5), that was unfailingly due to ungraftable right coronary artery targets. Discussion BITA only revascularization was a valuable and safe procedure, with favorable results in terms of morbidity and mortality at a 5 years' follow-up.

Status of cardiovascular surgery in Japan between 2017 and 2018: A report based on the Japan cardiovascular surgery database 2. Isolated coronary artery bypass surgery

2021 ◽  
pp. 021849232098149
Author(s):  
Aya Saito ◽  
Hiraku Kumamaru ◽  
Noboru Motomura ◽  
Hiroaki Miyata ◽  
Shinichi Takamoto
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Internal Thoracic Artery ◽  
Cardiovascular Surgery ◽  
Artery Bypass ◽  
Clinical Results ◽  
Graft Material ◽  
Off Pump ◽  
Left Anterior Descending Artery ◽  
Pump Coronary Artery Bypass

Background Clinical outcomes (as national clinical data) of isolated coronary artery bypass grafting have been successively reported, based on data registered in the Japan Cardiovascular Surgery Database, since 2013. In this study, we analysed the clinical results of isolated coronary artery bypass from 2017 to 2018 as a biannual report. Methods Data from the Japan Cardiovascular Surgery Database on isolated coronary artery bypass performed in 2017 and 2018 were reviewed for preoperative characteristics, postoperative outcomes, and choice of graft material for the left anterior descending artery. Results Isolated off-pump coronary artery bypass was performed in 54.6% ( n = 14,684) of all coronary artery bypass cases ( n = 26,913), and graft material for the left anterior descending artery was the left internal thoracic artery in 76.4% of cases and the right internal thoracic artery in 19.0% of cases. Operative mortality was 1.5% in elective cases (on-pump coronary artery bypass 1.9% and off-pump 1.2%, p < 0.001), 7.4% in emergency cases (on-pump 10.2% and off-pump 4.3%, p < 0.001), and 2.5% overall. Postoperative morbidity was generally lower in off-pump coronary artery bypass. The severity of surgery with expected mortality, evaluated using JapanSCORE II, is increasing every year. Conclusions Our findings suggest that short-term operative results for isolated coronary artery bypass are stable, and operative candidates are shifting to higher-risk patients.

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