title: [Method of proximal anastomosis with a new assist device].
abstract: Various devices have been invented for proximal anastomosis performed during coronary bypass surgery. Enclose II allows a handling of the needle to be similar to a single cross clamp proximal anastomosis with almost no blood loss. However, when creating the anastomotic hole, it is difficult to determine whether an incision into the aortic wall will extend to the intima, and in some instances there is a risk that the hemostatic membrane may be injured. With Enclose II's hemostatic confirmation tube, the hemostatic membrane is opened and the tube is inserted into the aortic wall. The vent plug of the extension tube is opened, blood fills between the aortic wall and the instrument, and air is removed. An isotonic saline solution is injected and the pressure checked to insure that no air enters. An incision into the aortic wall is then made with a scalpel. When the intima is pierced, isotonic saline solution will gush out. In this way, one can prevent injury to the hemostatic membrane and ensure a correctly pierced anastomotic hole in the intima--even with just 1 punch.
authors.affiliation: Department of Cardiac Surgery, Aichi Prefectual Cardiovascular and Respiratory Center, Ichinomiya, Japan.
authors.forename: Tadahito
authors.initials: T
authors.lastname: Eda
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation*; D001026:Coronary Artery Bypass / Q000295:instrumentation* / Q000379:methods*; D006801:Humans