title: Application of a new suture material called the U-Clip for composite and sequential grafting with off-pump coronary bypass surgery.
abstract: BACKGROUND
  The U-Clip was found to facilitate the interrupted anastomosis of coronary artery bypass grafts (CABG). This device may be beneficial especially in multivessel off-pump CABG (OPCAB) using composite grafts or sequential anastomosis. The aim of this study was to evaluate our early clinical experience using the U-Clip in OPCAB cases.
  
  
  METHODS
  This retrospective study included 118 patients who underwent off-pump CABG between 2001 and 2004. The mean age of the 91 men and 27 women was 69.5 +/- 8.0 years (range, 47-85). The U-Clip was adopted for sewing 73 proximal ends of the free graft to the side or end of the inflow conduit to prepare the composite graft. The U-Clip was also applied to 112 distal anastomoses, especially to the side-to-side anastomosis of the sequential graft.
  
  
  RESULTS
  Hospital mortality rate was 0.8% (1/118). The early patency rate of distal anastomoses using the U-Clip was 95% (96/101). The early patency rate of proximal anastomoses using the U-Clip was 98.4% (62/63). Interim angiography was performed in 12 patients (range, 3.8-42 months; average, 16 months). In these 12 patients, a total of 8 proximal anastomoses of conduits using the U-Clip were all patent without stenosis. The patency rate of a total of 10 distal anastomoses in the 12 patients using the U-Clip was 100%.
  
  
  CONCLUSIONS
  The U-Clip-interrupted anastomosis enables a safe, definite, and rapid end-to-end or end-to-side connection of arterial grafts. We therefore consider the U-Clip to be a useful suture material especially for multivessel OPCAB using multiple arterial grafts.
authors.affiliation: Department of Cardiovascular Surgery, School of Medicine, Fukuoka University, Fukuoka, Japan. morisige@fukuoka-u.ac.jp
authors.forename: Noritsugu
authors.initials: N
authors.lastname: Morishige
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Hayashida
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Ito
authors.forename: Hideki
authors.initials: H
authors.lastname: Teshima
authors.forename: Kazuma
authors.initials: K
authors.lastname: Takeuchi
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Iwahashi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Tashiro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000295:instrumentation*; D047549:Coronary Artery Bypass, Off-Pump / Q000295:instrumentation*; D003324:Coronary Artery Disease / Q000601:surgery*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013525:Surgical Instruments; D016896:Treatment Outcome