Background: The long-term patency rate of saphenous vein grafts for myocard
ial revascularization is poor (50% at 10 years). Half of the patent grafts
develop severe atherosclerosis. In this paper, we report on an implantation
technique and an in vivo evaluation of a device that creates a ventriculoc
oronary artery bypass (VCAB(TM))*, a permanent transmyocardial channel betw
een the left ventricle and a coronary artery.
Methods: An L-shaped titanium tube with an exterior polyester cuff was impl
anted from the base of the left ventricle to the proximal left anterior des
cending coronary artery in 11 juvenile domestic pigs using a beating heart
approach. Flow rates were measured at implantation. Patency was assessed wh
en explanted at two weeks.
Results: The flow rate through the device after implantation was 76% of bas
eline. Forward flow occurred during systole. The patency rate was 91% at tw
o weeks. Histologic analysis showed the formation of an organizing tissue a
t the coronary interface.
Conclusions: These preliminary studies show the promise of perfusing ischem
ic myocardium with systolic flow. Patency of the transmyocardial titanium c
onduit was excellent at two weeks and warrants longer duration studies.