Clinical experience with the CorLink device for proximal anastomosis of the saphenous vein to the aorta: a clinical, prospective, and randomized study.
BACKGROUND
Avoiding tangential clamping of the ascending aorta during coronary bypass operations reduces the trauma to the aorta and may avoid local particulate embolization.


METHODS
From December 2000 to May 2001, 21 male patients, mean age 64.1 +/- 7.2 years (range, 46-76 years), with coronary artery 2-vessel (n = 3) and 3-vessel (n = 18) disease were divided randomly into 2 groups and underwent myocardial revascularization. In 11 patients an aorta-saphenous vein graft anastomosis was performed with the CorLink device for anastomosis between the saphenous vein and the ascending aorta. Ten patients served as control subjects. In these patients the central bypass anastomosis was performed with a 6-0 running suture. Clinical follow-up was performed 1 month and 3 months postoperatively. Six months after surgery, multislice computed tomography was performed to evaluate bypass patency for all patients.


RESULTS
Mean number of study vessels was 1.2 +/- 0.4 in the CorLink group and 1.5 +/- 0.5 in the control group. In the CorLink group, 13 additional arterial and vein grafts were performed, and in the suture control group 15 additional mammary artery grafts were carried out. No intraoperative complications occurred. In 2 CorLink anastomoses an additional stitch was necessary because of minor bleeding. Follow-up was carried out at 6 months with multislice computed tomography for all patients and showed only 1 study vessel occlusion in the CorLink group. All 62 other bypass grafts were revealed to be patent and had anastomoses of good quality.


CONCLUSIONS
Our experience suggests that the CorLink device is a safe and effective technique for anastomosis between saphenous vein grafts and the ascending aorta. The CorLink device could be used for totally endoscopic coronary bypass operations. Further randomized studies enrolling a larger number of patients are necessary to determine which patients may benefit the most from this procedure.
Riess
Friedrich-Christian
FC
Department of Cardiac Surgery, Albertinen-Krankenhaus, Suentelstrasse 11a, 22457 Hamburg, Germany. Friedrich-Christian.Riess@albertinen.de
Helmold
Hanns
H
Hilfer
Irene
I
Bader
Ralf
R
Stripling
Jan
J
Loewer
Christine
C
Wesner
Frank
F
Bleese
Niels
N
D000368:Aged; D000714:Anastomosis, Surgical / Q000295:instrumentation*; D001011:Aorta / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000295:instrumentation*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012501:Saphenous Vein / Q000601:surgery*