Evaluation of a new device for quick sutureless coronary artery anastomosis in surviving sheep

Objective: A new device for performing quick sutureless vascular anastomosi s by means of stent technology has recently been developed by Jomed Interna tional, Helsingborg, Sweden. The efficacy of this GraftConnector was studie d in a sheep model. Methods: In adult sheep, a left anterior thoracotomy un der the fourth rib extended across the sternum gave good access to the left anterior descending branch (LAD) and the right internal mammary artery (RI MA). On beating hearts, the GraftConnector group had the RIMA connected to the LAD by means of the new device, while the control animals had the same anastomoses sutured with continuous 7-0 polypropylene sutures. The rime for completing the anastomosis (ischemic time) was recorded and the blood flow in the RIMA was recorded with the proximal LAD open and closed, respective ly. An intra-operative fluoroscopy with contrast injection directly into th e graft was done. Finally the proximal LAD was ligated. The surviving anima ls are to be followed up. Results: Seven (46%) of the 15 animals operated o n with the traditional suturing technique and seven (63%) of the II GraftCo nnector sheep survived the procedures and are to be followed up. The 11 ana stomoses done with the GraftConnector were completed in 2.41 +/- 0.2 min, a nd the 14 anastomoses sutured with continuous suture were completed in 6.93 +/- 0.419 min (P < 0.0001). The RIMA blood-flows in the two groups were co mparable and are presented. All the surviving animals had open anastomoses at fluoroscopy. Conclusions: Quick coronary artery anastomoses without sutu ring on beating hearts can be completed with the new GraftConnector. The Gr aftConnector creates reproducible anastomoses in much less time than suturi ng, the per-operative mortality in the GraftConnector Group was accordingly lower. Long-time follow-up of the patency in surviving animals is pending. The presented device may ultimately permit quick anastomoses endoscopicall y. (C) 2000 Elsevier Science B.V. All rights reserved.