title: An automatic sutureless coronary anastomotic device: initial results of an animal study.
abstract: BACKGROUND
  The efficacy and long-term patency of a new distal anastomotic device (DAD) for the creation of rapid, sutureless end-to-side venous or arterial coronary artery bypass graft anastomoses were tested in a sheep model.
  
  
  METHODS
  The DAD was used on the beating hearts of 34 sheep to create 20 anastomoses between saphenous veins (n = 9) or internal mammary arteries (n = 11) and various coronary arteries. Fourteen conventional hand-sutured anastomoses (7 veins; 7 internal mammary arteries) served as controls. The sheep were sacrificed 1 day, 1 week, and 1, 3, and 6 months after surgery.
  
  
  RESULTS
  The immediate patencies of all anastomoses were proven by the rates and pattern of flow. There were no significant differences between the DAD and suture anastomosis groups in presacrifice pulsatility index and occlusion rate. The histomorphometric studies showed complete intimal bridging over the DAD with no significant differences between DAD and suture anastomoses with respect to tissue response, mural injury, inflammation, and adventitial fibrosis.
  
  
  CONCLUSIONS
  The DAD enables the creation of rapid, efficient, and sutureless venous or arterial coronary anastomoses. The long-term results of histomorphometric studies show that the results with the DAD are comparable with those of conventional hand-sutured anastomoses.
authors.affiliation: Department of Cardiac Surgery, Rambam Medical Center, Israel Institute of Technology, Haifa, Israel. y_bar_el@ramban.health.gov.il
authors.forename: Yaron
authors.initials: Y
authors.lastname: Bar-El
authors.forename: Fermin O
authors.initials: FO
authors.lastname: Tio
authors.forename: Rona
authors.initials: R
authors.lastname: Shofti
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D000818:Animals; D001026:Coronary Artery Bypass / Q000295:instrumentation* / Q000379:methods; D003331:Coronary Vessels / Q000601:surgery; D004867:Equipment Design; D005260:Female; D008323:Mammary Arteries / Q000637:transplantation*; D023421:Models, Animal; D012501:Saphenous Vein / Q000637:transplantation*; D012756:Sheep; D013525:Surgical Instruments; D013536:Suture Techniques; D014654:Vascular Patency