Interrupted distal anastomosis: the interrupted "porcupine" technique.
The distal coronary artery bypass graft anastomosis created by an interrupted technique using nitinol clips is likely superior to that created with continuous suture because surgeons place clips with optimal visualization, and the anastomosis exhibits optimal compliance and cannot become a "purse-string" once constructed. Skillful use of the clips allows the surgeon to work in the ever more cramped quarters of the minithoracotomy or minimally invasive incision. Anastomosing vessels without knot tying is a valuable practice in the application of remote and robotic surgeries.
Hamman
Baron L
BL
Baylor University Medical Center, Clinical Cardiology Research Center, 3600 Gaston Avenue, Barnett Tower 1202, Dallas, TX 75246, USA. bhamman@heartplace.com
White
Cory H
CH
D001026:Coronary Artery Bypass / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D013525:Surgical Instruments