Ventriculocoronary 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 and ventriculocoronary artery bypass procedure that creates a permanent transmyocardial channel between the left ventricle and a coronary artery.


METHODS
The transmyocardial device, an L-shaped titanium tube with a meshed distal tip and an exterior polyester cuff, was implanted from the base of the left ventricle to the proximal left anterior descending coronary artery in 11 healthy juvenile domestic pigs using a beating-heart approach. Flow rates were measured at implant. Patency was assessed at explant for surviving 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 100% at 2 weeks and 75% at 4 weeks. Histologic analysis showed little to no intimal proliferation at the coronary interface.


CONCLUSIONS
This short-duration study shows promise for perfusing ischemic myocardium with systolic flow. The transmyocardial titanium conduit and treated coronary artery patency was good at 2 and 4 weeks and warrants further studies.
Emery
R W
RW
Cardiac Surgical Associates, Minneapolis, Minnesota 55407, USA. dremery@csa-heart.com
Eales
F
F
Van Meter
C H
CH
Knudson
M B
MB
Solien
E E
EE
Tweden
K S
KS
D000818:Animals; D001672:Biocompatible Materials; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000601:surgery*; D004867:Equipment Design; D006352:Heart Ventricles / Q000601:surgery*; D020007:Implants, Experimental; D019060:Minimally Invasive Surgical Procedures; D009204:Myocardial Revascularization / Q000295:instrumentation* / Q000379:methods*; D013552:Swine; D014025:Titanium
D001672:Biocompatible Materials; D014025:Titanium