title: First clinical experience with the HEARTSTRING, a device for proximal anastomoses in coronary surgery.
abstract: 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.
authors.affiliation: Department of Cardiac Surgery, Grosshadern Medical Center, Ludwig Maximilians University Munich, Munich, Germany. calin.vicol@med.uni-muenchen.de
authors.forename: Calin
authors.initials: C
authors.lastname: Vicol
authors.forename: Martin
authors.initials: M
authors.lastname: Oberhoffer
authors.forename: Georg
authors.initials: G
authors.lastname: Nollert
authors.forename: Sandra
authors.initials: S
authors.lastname: Eifert
authors.forename: Peter
authors.initials: P
authors.lastname: Boekstegers
authors.forename: Bernd
authors.initials: B
authors.lastname: Wintersperger
authors.forename: Bruno
authors.initials: B
authors.lastname: Reichart
mesh_terms: 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