First clinical experience with the HEARTSTRING, a device for proximal anastomoses in coronary surgery.
OBJECTIVE
The HEARTSTRING is a device designed to enable the creation of a clampless hand-sewn proximal anastomosis.


METHODS
Seventy-six patients who underwent myocardial revascularization had 113 proximal anastomoses created by the HEARTSTRING. Fifty-five procedures were performed on cardiopulmonary bypass and 21, off pump.


RESULTS
Of 114 intended proximal anastomoses, 113 (99.1%) were successfully performed using the HEARTSTRING. The conduits anastomosed proximal with support of the HEARTSTRING were in 92 cases saphenous veins and in 21 cases radial arteries. Mean time to perform a HEARTSTRING-supported anastomosis was 6.6 +/- 1.2 minutes. One patient (1.3%) died postoperatively; the death was not device related. In 1 additional patient (1.3%), a stroke most likely due to air embolism occurred. Forty-nine patients (64.5%) underwent a predischarge coronary angiography (n = 20) or a contrast multislice computed tomography (n = 29). Of 76 grafts with a HEARTSTRING-supported proximal anastomosis, 74 (97.4%) were patent in these 49 patients.


CONCLUSIONS
Our initial clinical experience with the HEARTSTRING demonstrates safety, reliability, and ease of use. Side clamping of the ascending aorta can be avoided, potentially decreasing the incidence of neurologic complications.
Vicol
Calin
C
Department of Cardiac Surgery, Grosshadern Medical Center, Ludwig Maximilians University Munich, Munich, Germany. calin.vicol@med.uni-muenchen.de
Oberhoffer
Martin
M
Nollert
Georg
G
Eifert
Sandra
S
Boekstegers
Peter
P
Wintersperger
Bernd
B
Reichart
Bruno
B
D000368:Aged; D000714:Anastomosis, Surgical / Q000295:instrumentation*; D015906:Angioplasty, Balloon, Coronary; D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D003327:Coronary Disease / Q000601:surgery; D004867:Equipment Design; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology