Coronary artery bypass with the use of a magnetic distal anastomotic device: surgical technique and preliminary experience.
BACKGROUND
At present there is little reported experience in the application of new technology in the performance of distal coronary anastomoses in the clinical setting. The aim of our study was to evaluate the feasibility of using the Ventrica magnetic vascular positioner (MVP) device for left internal thoracic artery (LITA)-to-left anterior descending (LAD) coronary anastomosis.


METHODS
We present our preliminary experience of the first 14 coronary artery cases performed in the United Kingdom from April 2003 to December 2003. The selection criteria, surgical technique, clinical outcome, advantages or disadvantages, and future implications are all discussed.


RESULTS
The device was used in 12 patients for LITA-to-LAD anastomosis and in 2 patients for the proximal anastomosis of a radial artery Y-graft from the LITA to the circumflex territories. The first 3 patients underwent coronary artery bypass graft with the use of cardiopulmonary bypass, and the remaining 9 underwent surgery performed using an off-pump coronary artery bypass technique. No mortality or device-related events were observed in these patients. The anastomosis time in our series was 5.6 +/- 1.99 minutes, and the blood loss was 914 +/- 234 mL. The mean length of stay was 5.8 +/- 1.16 days.


CONCLUSIONS
The MVP system is a novel distal coronary anastomotic device that is quick, simple, and effective, producing consistently reliable coronary anastomoses in a wide variety of coronary bypass procedures. Early results are encouraging, and further studies are required in order to evaluate long-term efficacy of this system in the rapidly changing world of coronary revascularization.
Athanasiou
Thanos
T
The National Heart and Lung Institute, Imperial College of Science, Technology and Medicine, Department, of Cardiothoracic Surgery, St Mary's Hospital, London, UK. tathan5253@aol.com
Ashrafian
Hutan
H
Glenville
Brian
B
Casula
Roberto
R
D000714:Anastomosis, Surgical / Q000295:instrumentation* / Q000379:methods; D001026:Coronary Artery Bypass / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008280:Magnetics / Q000295:instrumentation* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome