Ventriculo coronary artery bypass results using a mesh-tipped device in a porcine model

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.