title: Coronary end-to-side sleeve anastomosis using adhesive in off-pump bypass grafting in the pig.
abstract: BACKGROUND
  In the exploration of facilitated coronary anastomosis strategies, we assessed a new octylcyanoacrylate adhesive in combination with a modified end-to-side sleeve anastomosis in off-pump bypass grafting in the pig.
  
  
  METHODS
  Sleeve-adhesive anastomoses (n = 20) were evaluated intraoperatively, at 3 days (n = 4), and at 5 weeks (n = 16) in an off-pump, low (< or = 15 mL/min; n = 10) and high flow (approximately 60 mL/min; n = 10) porcine bypass model. All anastomoses were examined by flow measurement, angiography, and histology.
  
  
  RESULTS
  Anastomosis construction took 8.5 minutes (6.7 to 10.2 minutes; median [15th to 85th percentile]). At 5 weeks, all anastomoses were fully patent (FitzGibbon grade A). The adhesive did not cause impaired vessel wall healing, but was surrounded by a focal acute and limited chronic (foreign body giant cells occasionally seen) inflammatory reaction at the adventitial application site.
  
  
  CONCLUSIONS
  Octyl-cyanoacrylate tissue adhesive combined with end-to-side internal mammary to coronary artery sleeve anastomosis construction proved to be feasible, even in low bypass graft flow conditions (< or = 15 mL/min; prothrombotic milieu) in the pig and deserves interest in exploration of facilitated anastomosis strategies in coronary artery bypass grafting.
authors.affiliation: Heart Lung Center Utrecht, University Medical Center Utrecht, The Netherlands.
authors.forename: Marc P
authors.initials: MP
authors.lastname: Buijsrogge
authors.forename: Cees W J
authors.initials: CW
authors.lastname: Verlaan
authors.forename: Mattie H P
authors.initials: MH
authors.lastname: van Rijen
authors.forename: Paul F
authors.initials: PF
authors.lastname: Gründeman
authors.forename: Cornelius
authors.initials: C
authors.lastname: Borst
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D001783:Blood Flow Velocity / Q000502:physiology; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D003326:Coronary Circulation / Q000502:physiology; D003331:Coronary Vessels / Q000473:pathology; D003487:Cyanoacrylates; D005260:Female; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D013536:Suture Techniques; D013552:Swine; D014014:Tissue Adhesives; D014945:Wound Healing / Q000502:physiology
chemical_list: D003487:Cyanoacrylates; D014014:Tissue Adhesives; C100832:octyl 2-cyanoacrylate