A new needle driver for minientry coronary artery bypass.
OBJECTIVE
This article describes our clinical experience with a new needle driver (Olympus, Tokyo, Japan), which we have produced to facilitate minithoracotomy or port-access coronary artery anastomosis with the running suture technique.


METHODS
The needle driver is 21 cm long, weighs 38 g, and has a grip shaft 1.4 cm in diameter. The device is held like a pencil. A side lever and a revolving disk in the shaft are manipulated with the fingers; a fine needle with a 7-0/8-0 monofilament suture can be grasped/released and driven to penetrate the coronary arterial wall. This device was employed in 10 consecutive patients (8 men, 2 women, 73 +/- 7.5 years old), and off-pump bypass to the left anterior descending artery was achieved using the left internal thoracic artery or vein via a minithoracotomy (4.2 +/- 0.6 cm long).


RESULTS
There was no instrument-related injury during each anastomosis. The mean sewing time per anastomosis was 12 minutes (range, 8-18 minutes). Angiography confirmed the patency of the graft in all cases.


CONCLUSIONS
Although our experience is limited, we consider the present needle driver to be a viable device for facilitating off-pump, minientry coronary artery anastomosis with the suturing technique.
Ohtsuka
Toshiya
T
Department of Cardiovascular Surgery, Tokyo Metropolitan Fuchu General Hospital, Tokyo, Japan.
Ninomiya
Mikio
M
Nonaka
Takahiro
T
Maemura
Taisei
T
D000714:Anastomosis, Surgical / Q000295:instrumentation*; D001026:Coronary Artery Bypass / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D008904:Miniaturization; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D009339:Needles; D013536:Suture Techniques / Q000295:instrumentation*; D016896:Treatment Outcome