Experimental coronary artery occlusion: relevance to off-pump cardiac surgery.
Mechanical coronary artery occlusion is required for minimally invasive direct coronary artery bypass and off-pump coronary artery bypass surgery. It is important that the method of occlusion be minimally traumatic. Chronic effects of these methods have never been studied. Temporary occlusion of coronaries utilizing suture snare, silastic loop snare, and bulldog clamp was carried out in 12 Yucatan pigs. Three animals each were sacrificed acutely and at 3, 6, and 12 months. The area of occlusion of each vessel was examined by light microscopy and the degree of damage recorded. In the animals sacrificed acutely, there was more damage using the suture snare than with the other 2 methods, but there was minimal damage at longer intervals. There was slight damage acutely and chronically with the bulldog technique. No damage was seen acutely with the silastic loop technique, but some late damage was found. The techniques of coronary artery dissection and occlusion used for minimally invasive and off-pump bypass surgery may contribute to early postoperative graft occlusion.
Hsi
Charles
C
Division of Cardiothoracic Surgery, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA. charles.hsi@umassmed.edu
Cuenoud
Henri
H
Soller
Babs R
BR
Kim
Hun
H
Favreau
Janice
J
Vander Salm
Thomas J
TJ
Moran
John M
JM
D000714:Anastomosis, Surgical / Q000009:adverse effects*; D000818:Animals; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003250:Constriction; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000601:surgery*; D003331:Coronary Vessels / Q000293:injuries* / Q000601:surgery*; D004195:Disease Models, Animal; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000209:etiology*; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D011183:Postoperative Complications; D013536:Suture Techniques / Q000009:adverse effects*; D013552:Swine; D013997:Time Factors; D014111:Tourniquets / Q000009:adverse effects*