title: A new clip device for the construction of vascular interrupted anastomoses in congenital cardiac surgery.
abstract: BACKGROUND
  Many different mechanical vascular anastomotic devices have been developed recently, mostly rigid stenting mechanisms applicable only in coronary artery bypass grafting surgery. U-Clips, however, allow the precise construction of any vascular interrupted anastomosis, preserving pulsatility and perhaps growth potential.
  
  
  METHODS
  We report the first use worldwide of U-Clips for congenital cardiac surgery in 10 pediatric patients (mean age, 2.3 +/- 1.7 years). The operations took place between July 2001 and July 2002 for coarctation repair (3 patients), Glenn shunt (5 patients), Blalock-Taussig shunt (1 patient), and arterial switch (1 patient).
  
  
  RESULTS
  Device handling, primary hemostasis, and patency were excellent, and no device-related complications occurred. Because of the learning curve, aortic cross-clamp times were significantly longer for the repair of coarctation with U-Clips than with the running-suture technique (21.7 +/- 2.3 minutes versus 14.4 +/- 2 minutes; P = .012). Postoperative recoveries were uneventful in all patients except for a baby with pulmonary atresia with intact ventricular septum, who died after 62 days. After a mean follow-up period of 11.9 +/- 4.4 months, echocardiographic controls of all anastomoses showed nonturbulent flow without any restriction.
  
  
  CONCLUSIONS
  The U-Clip device may be a useful adjunct in congenital cardiac surgery for facilitating the creation of interrupted vascular anastomoses. Further evaluation is warranted for determining the long-term benefits of these devices with respect to growth preservation and restenosis.
authors.affiliation: Department of Cardiovascular Surgery, University Hospital, Bern, Switzerland. pascal.berdat@insel.ch
authors.forename: Pascal A
authors.initials: PA
authors.lastname: Berdat
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Pfammatter
authors.forename: Mladen
authors.initials: M
authors.lastname: Pavlovic
authors.forename: Thierry
authors.initials: T
authors.lastname: Carrel
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation; D001017:Aortic Coarctation / Q000601:surgery*; D002675:Child, Preschool; D004867:Equipment Design; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D013525:Surgical Instruments; D013536:Suture Techniques / Q000295:instrumentation*