Six-month healing of the nonocclusive coronary anastomotic connector in an off-pump porcine bypass model.
OBJECTIVE
This pilot study evaluates the anastomotic healing of the Excimer Laser Assisted Nonocclusive Anastomosis coronary connector at 6 months in a porcine off-pump coronary artery bypass (OPCAB) model.


METHODS
Left internal thoracic artery to left anterior descending coronary artery bypass in two animals and left internal thoracic artery to left anterior descending coronary artery and right internal thoracic artery to right coronary artery bypasses in one animal were evaluated intraoperatively and at 6 months. The anastomoses (n = 4) were examined by angiography, intravascular ultrasound, optical coherence tomography, scanning electron microscopy, and histology.


RESULTS
At follow-up, all anastomoses (n = 4) were fully patent (FitzGibbon grade A). Scanning electron microscopy demonstrated complete endothelial coverage of the anastomotic surface, and histology showed minimal streamlining intimal hyperplasia. The in vivo intravascular ultrasound and optical coherence tomography acquisitions confirmed histologic findings. Optical coherence tomography demonstrated 0.06-mm intimal coverage of the intraluminal part of the connector along the full circumference of the anastomosis.


CONCLUSIONS
In this pilot study, the Excimer Laser Assisted Nonocclusive Anastomosis coronary connector showed an excellent healing response on the long-term in the porcine OPCAB model. Hence, this new concept might be a potential alternative to hand-sutured anastomosis in (minimally invasive) OPCAB surgery.
From the Departments of *Cardiothoracic Surgery, †Cardiology, and ‡Experimental Cardiology, Heart and Lungs Division, University Medical Center Utrecht, Utrecht, The Netherlands.
David
D
Stecher
Pierfrancesco
P
Agostoni
Gerard
G
Pasterkamp
Imo E
IE
Hoefer
Lex A
LA
van Herwerden
Marc P
MP
Buijsrogge
D000714:Anastomosis, Surgical / Q000295:instrumentation; D000818:Animals; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D004195:Disease Models, Animal; D008297:Male; D008855:Microscopy, Electron, Scanning; D013552:Swine; D013895:Thoracic Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D041623:Tomography, Optical Coherence; D018084:Ultrasonography, Interventional; D014945:Wound Healing