Background. A thoracoscopic approach to coronary bypass grafting warrants r
enewed search for facilitated vascular anastomosis methods. We reassessed t
issue adhesion, sealing properties, and histotoxicity of iso-butyl-cyanoacr
ylate, in a simplified anastomosis model.
Methods. In 12 Dutch landrace pigs, five arteriotomies were made in each ca
rotid artery. The arteriotomies were closed by conventional microvascular s
uturing or by pericardial patch (Peri-Strips) and iso-butyl-cyanoacrylate.
The animals were sacrificed at 2 hours (n = 2), 2 days (n = 5), and 4 weeks
(n = 5). The arteries were examined by flow measurement, angiography, and
histologic analysis.
Results. The time required to close arteriotomies by conventional suturing
was 257 +/- 43 seconds (mean +/- SD) and by glued patch 51 +/- 27 seconds (
p < 0.001). In all arteriotomies covered by glued patch, complete hemostasi
s was obtained. At 2 days and 4 weeks, with both methods the same histologi
c results were observed. At follow-up, all carotid arteries were patent wit
hout stenoses.
Conclusions. Arteriotomy closure by glued patch was simple, fast, reliable,
and without signs of histotoxicity. Adhesives deserve to be reconsidered a
s an alternative to suturing in closed chest beating-heart coronary surgery
. (C) 2000 by The Society of Thoracic Surgeons.