U-clip anastomoses in coronary artery bypass grafting: initial clinical experience.
BACKGROUND
Recent studies suggest that the U-Clip interrupted coronary artery anastomosis is superior to continuous suture. However, clinical experience with this device is limited.


OBJECTIVE
To evaluate our initial clinical experience with the U-Clip technology.


METHODS
Outcomes of 59 patients undergoing isolated coronary artery bypass grafting (CABG) using U-Clips (UCs) were compared to outcomes of 138 patients undergoing CABG using conventional sutures (Conv).


RESULTS
The average number of distal anastomoses was similar in the groups (UC, 2.9; Conv, 3.2; P = .33). Also similar were the number of arterial grafts (1.6 versus 1.5, P = .4), percentage of sequential anastomoses (22% versus 12%, P = .058), and percentage performed off pump (27% versus 28%, P = .74). Cardiopulmonary bypass and aortic crossclamp times were longer in the UC group (98 +/- 27 versus 81 +/- 20 minutes, P = .001; 63 +/- 25 versus 54 +/- 24 minutes, P = .028). Rates of operative mortality (UC, 1.69%; Conv, 0.7%), postoperative myocardial infarction (0% each), stroke (0% each), renal failure (2% versus 1.4%), and blood transfusion (53% versus 58%) were not statistically different. Average follow-up in 36 (61%) of UC patients was 5 +/- 2 months (range, 1-7 months). One patient died from a non-cardiacrelated cause. At the time of follow-up 90% of patients were in angina class I-II.


CONCLUSIONS
The U-Clip interrupted anastomosis technique is versatile and safe and is associated with excellent short-term outcomes.
Shemin
Richard J
RJ
Boston Medical Center, Boston, Massachusetts 02118, USA. richard.shemin@bmc.org
Shapira
Oz M
OM
Pawar
Rahul V
RV
Bao
Usheng
U
Sayeed-Shah
Umer
U
Lazar
Harold L
HL
D000368:Aged; D000714:Anastomosis, Surgical / Q000295:instrumentation; D001026:Coronary Artery Bypass / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013525:Surgical Instruments; D013997:Time Factors