Guidant Heartstring: initial experience in OPCAB surgery

Area of Science:

• Cardiovascular Surgery
• Medical Devices
• Surgical Innovation

Background:

• Off-pump coronary artery bypass (OPCAB) surgery aims to reduce complications associated with cardiopulmonary bypass.
• Aortic side clamping can lead to complications like stroke and myocardial ischemia.
• Hemostatic devices offer potential solutions for creating anastomoses without clamping.

Purpose of the Study:

• To assess the feasibility of the Heartstring hemostatic seal system for proximal anastomoses.
• To evaluate its use in off-pump coronary artery bypass surgery without aortic side clamping.
• To determine safety and efficacy in patients with calcified aortas.

Main Methods:

• Prospective study of 50 proximal anastomoses in 29 consecutive patients with calcified aortas.
• Utilized the Heartstring hemostatic seal system for anastomosis creation.
• Assessed bypass graft patency via intraoperative flow measurements and neurological outcomes.

Main Results:

• Successful completion of anastomoses without the need for aortic side clamping.
• A learning curve of approximately 10 devices was observed.
• No perioperative ischemic events or postoperative neurological complications were reported.
• Bypass graft flow averaged 53.7 L/min with no residual foreign material.

Conclusions:

• The Heartstring system is a feasible and safe option for proximal anastomoses in OPCAB surgery.
• Eliminates the need for aortic side clamping, potentially reducing associated risks.
• Offers a method for creating anastomoses without leaving foreign material in the aorta.