title: Nonpenetrating clips for coronary anastomosis.
abstract: BACKGROUND
  A nonsuture clip technique (nonpenetrating titanium clips applied to everted tissue edges at high compressive forces) was used to perform coronary anastomoses in a clinical setting.
  
  
  METHODS
  Clipped coronary anastomoses were performed in 10 patients. The anastomoses incorporated the left internal mammary artery to the left anterior descending artery (n = 1) and the saphenous vein to the right coronary artery (n = 5), the posterior descending artery (n = 2), the diagonal artery (n = 2), and one vein-to-vein proximal anastomosis (n = 1).
  
  
  RESULTS
  The mean duration for completion of the anastomoses was 15 minutes (range, 7 to 20 minutes). This time was reduced from 20 minutes at the beginning of the clinical experience to 7 minutes for the last 3 patients. No technical complication was related to clip application and all patients had uneventful outcomes. Three anastomoses studied by coronary angiography were patent without stenosis.
  
  
  CONCLUSIONS
  The clipped anastomotic technique has a rapid learning curve, the same safety as suture methods, and the potential for facilitating endoscopic vascular reconstructions.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hôpital de la Pitié, Paris, France. natafpat@worldnet.fr
authors.forename: P
authors.initials: P
authors.lastname: Nataf
authors.forename: W
authors.initials: W
authors.lastname: Kirsch
authors.forename: A C
authors.initials: AC
authors.lastname: Hill
authors.forename: T
authors.initials: T
authors.lastname: Anton
authors.forename: Y H
authors.initials: YH
authors.lastname: Zhu
authors.forename: R
authors.initials: R
authors.lastname: Ramadan
authors.forename: L
authors.initials: L
authors.lastname: Lima
authors.forename: A
authors.initials: A
authors.lastname: Pavie
authors.forename: C
authors.initials: C
authors.lastname: Cabrol
authors.forename: I
authors.initials: I
authors.lastname: Gandjbakhch
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation*; D001026:Coronary Artery Bypass / Q000295:instrumentation*; D006801:Humans; D013525:Surgical Instruments