Clampless arterial coronary artery bypass grafting with the use of magnetic coupling devices.
BACKGROUND
The aim of our study was to evaluate the feasibility of using the Ventrica MVP device to perform proximal anastomoses as part of the clampless off-pump coronary artery bypass (OPCAB) arterial revascularization procedure.


METHODS
We present our preliminary experience of these first nine coronary artery cases performed in the UK from April 2003 to December 2004.


RESULTS
The device was used in eight patients for the proximal anastomosis of a radial artery (n = 8) or right internal thoracic artery (n = 1) graft as a Y-graft from the left internal thoracic artery to the circumflex territories. One patient died in this series although the autopsy showed that the device was intact and free of clots and the reported cause of death was an acute cardiac event due to myocardial ischemia. Anastomotic patency was confirmed in five patients with the use of multidetector row computed tomography coronary angiogram. The anastomosis time in our series was 6.3 +/- 2.1 minutes and the blood loss 814 +/- 245 mL. The mean length of stay was 5.2 +/- 1.2 days. No other significant major morbidity events were observed postoperatively (neurological complications, renal failure, and reopening for bleeding). The assessment of quality of life at 6 months postoperatively using SF-36 questionnaires revealed improvement.


CONCLUSIONS
The versatile use of Ventrica MVP distal anastomotic device is feasible in clinical practice allowing surgeons to perform proximal anastomoses and arterial OPCAB surgery with short learning curve and without compromising the clinical outcome and quality of life.
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, United Kingdom. tathan5253@aol.com
Ashrafian
Hutan
H
Asrafian
Hutan
H
Krasopoulos
George
G
Purkayastha
Sanjay
S
Malinowski
Vitali
V
Al-Ruzzeh
Sharif
S
Glenville
Brian
B
De La Stanbridge
Rex
R
Casula
Roberto
R
D000368:Aged; D000369:Aged, 80 and over; D003250:Constriction; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000295:instrumentation*; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies