Objective: The Excimer laser-assisted nonocclusive anastomotic technique is a nonocclusive, facilitated bypass technique that is currently Conformité Européenne and Food and Drug Administration approved for clinical application in neurosurgery. In the present study, we assessed the safety and feasibility of a newly developed Excimer laser-assisted nonocclusive anastomosis-based prototype coronary anastomotic connector in an acute rabbit abdominal aortic bypass model before application in experimental coronary bypass surgery. In addition, 2 sealants were tested to facilitate anastomotic hemostasis in the current device prototype.
Methods: A total of 40 anastomoses were constructed on the abdominal aorta (3.5 mm outer diameter) of 10 rabbits. The anastomotic circumference was sealed by a surgical sealant to obtain complete hemostasis (BioGlue vs TachoSil). The anastomoses were evaluated by flow measurements construction time, hemostasis, histologic analysis, and burst pressure testing.
Results: The connector enabled a nonocclusive and fast (6.0 ± 1.7 minutes, mean ± SD [including sealing]) anastomosis construction and complete hemostasis in 95% (35/37). Sealing with BioGlue was faster than with TachoSil (19% vs 53% of construction time). Despite technical imperfections (7/40 failures to completely retrieve the flap by the laser), all 40 anastomoses were patent, showed reproducible construction with intima-adventitia apposition, streamlining thrombus coverage of the intraluminal laser rim, and no vessel wall damage. All anastomoses resisted ex vivo supraphysiologic pressures (> 300 mm Hg).
Conclusions: The results of the present study have demonstrated that the Excimer laser-assisted nonocclusive anastomotic connector is safe and reliable and can be efficiently applied in an acute rabbit abdominal aortic bypass model. Provided the limitations can be addressed, this easy-to-use and nonocclusive technique has the potential to facilitate minimally invasive coronary bypass surgery.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jtcvs.2012.05.061 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Coronary Connector Facilitated Total Endoscopic Coronary Artery Bypass: An Ex Vivo Feasibility Study.
Innovations (Phila)
December 2024
Cardiothoracic Surgery, UMC Utrecht, The Netherlands.
Objective: Totally endoscopic coronary artery bypass (TECAB) procedures pose significant challenges, motivating the development of Octocon, an automated endoscopic connector designed for coronary anastomoses in off-pump and endoscopic settings. This feasibility study aimed to assess Octocon's functionality and maneuverability in closed-chest conditions during robot-assisted TECAB simulations.
Methods: The Octocon deployment comprises a 3-step procedure.
Medium and long-term patency results of distal anastomosis connectors: a meta-analysis.
Ann Cardiothorac Surg
July 2024
Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Background: The difficulty of suturing perfect anastomoses in limited-access conditions prevents the transition of traditional coronary artery bypass grafting (CABG) to sternal-sparing approaches, even in the robotic era. Automated coronary anastomotic connector technologies may address these difficulties, but to date, none have achieved broad adoption. Besides versatility, ease-of-use and cost-effectiveness, the key performance parameter of such technology is anastomotic patency.
View Article and Find Full Text PDFAxillary necklace graft salvage of a locally infected Haemodialysis with Reliable Outflow (HeRO®) graft.
J Vasc Access
April 2024
Norfolk and Norwich Vascular Unit, Norfolk and Norwich University Hospital, Norwich, UK.
Background: A 48-year-old patient presented 4 months after insertion of a right sided Haemodialysis with Reliable Outflow (HeRO®, Merit Medical) graft with a discharging abscess at the site of the brachial artery anastomosis. There was localised involvement of the arterial Gore® Acuseal inflow graft that necessitated its removal. The venous outflow component was thought salvageable as infection was well localised to the region of the antecubital fossa.
View Article and Find Full Text PDFApico-aortic conduit: a readily available technical modification.
Eur J Cardiothorac Surg
May 2024
Department of Thoracic, Cardiac and Vascular Surgery, University Hospital Pontchaillou, Rennes, France.
When neither surgical valve replacement nor transcatheter aortic valve implantation is possible, performing an apico-aortic conduit remains a therapeutic option. This procedure has become rare and the rigid angled apical connectors usually used to facilitate ventricular anastomosis are no longer commercially available. We described the technique that we performed on a 60-year-old patient with readily available material.
View Article and Find Full Text PDFObjective: To describe the approach for placement of a transcerebellar fourth ventriculoperitoneal shunt for management of presumed fourth ventricle arachnoid diverticulum and secondary obstructive hydrocephalus of a dog. To describe the outcome of this procedure.
Study Design: Case report.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!