This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Jens Wippermann Thorsten Wahlers Johannes M. Albes Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Wippermann, J. Articles by Albes, J. M. Search for Related Content PubMed PubMed Citation Articles by Wippermann, J. Articles by Albes, J. M. Related Collections Minimally invasive surgery

Feasibility study of sutureless distal coronary anastomoses with degradable Y-shunt and tissue adhesives in a porcine off-pump model

^a Department of Cardiothoracic Surgery, University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
^b Department of Cardiothoracic Surgery, University Hospital Jena, Germany
^c Heart Center Brandenburg, Bernau, Germany

*Corresponding author. Tel.: +49 221 478 4128; fax: +49 221 478 4186.

E-mail address: jens.wippermann{at}uk-koeln.de (J. Wippermann).

The purpose of this study was to examine the feasibility of the combined use of intraluminal biodegradable shunts and surgical adhesives for sutureless distal coronary anastomosis. Eighteen LITA-LAD anastomoses were created in a porcine beating heart model. In group I (n=9) a custom-made silicone Y-shunt provided internal stability, while three different adhesives, N-butyl-2-cyanoacrylate-glue (CYAC); albumin-glutaraldehyde-glue (AG); fibrin-glue (FIB), were applied externally. In group II (n=9) biodegradable polydioxanone (PDS) shunts were used. All anastomoses were examined intraoperatively by flow measurement, blood leakage was quantified and physical strength was tested. In all pigs anastomoses could be created successfully at first attempt, but anastomotic leaks requiring additional sutures occurred in 6 animals. LITA-flow significantly decreased in both groups. A patency rate of 89.9% (8/9) was found in group I while it was 66.6% (5/9) in group II. The lowest amount of blood-loss was measured when CYAC adhesive was used while tensile strength was lowest in the FIB-anastomoses. Preliminarily we could demonstrate the feasibility of performing sutureless distal coronary anastomosis by means of a combination of adhesives and temporary intraluminal shunts. PDS-shunts, however, resulted in a high graft-occlusion rate, so that potentially less thrombotic materials need to be investigated.

Key Words: Sutureless coronary anastomosis; Degradable biomaterial; Tissue adhesive