Background. In this report we describe the in vivo evaluation of a device a
nd ventriculocoronary artery bypass procedure that creates a permanent tran
smyocardial channel between the left ventricle and a coronary artery.
Methods. The transmyocardial device, an L-shaped titanium tube with a meshe
d distal tip and an exterior polyester cuff, was implanted from the base of
the left ventricle to the proximal left anterior descending coronary arter
y in 11 healthy juvenile domestic pigs using a beating-heart approach. Flow
rates were measured at implant. Patency was assessed at explant for surviv
ing animals at 2 (n = 3) and 4 weeks (n = 4).
Results. Flow through the transmyocardial device after implantation was 74%
of base line. Forward flow occurred during systole. Luminal patency was 10
0% at 2 weeks and 75% at 4 weeks. Histologic analysis showed little to no i
ntimal proliferation at the coronary interface.
Conclusions. This short-duration study shows promise for perfusing ischemic
myocardium with systolic flow. The transmyocardial titanium conduit and tr
eated coronary artery patency was good at 2 and 4 weeks and warrants furthe
r studies. (C) 2001 by The Society of Thoracic Surgeons.