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Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
[New proximal anastomotic system in coronary artery bypass grafting]
1Department of Cardiovascular Surgery, Osaka City University Medical School, Osaka, Japan.
Insights
The Heartstring device enables clampless, hand-sewn proximal anastomoses during coronary artery bypass grafting. This innovative system shows high graft patency and reduced neurological complications in patients.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Surgical Techniques
Context:
- Coronary artery revascularization often requires complex anastomotic procedures.
- Traditional methods may involve aortic clamping, posing risks.
- Minimally invasive and off-pump techniques are increasingly preferred.
Purpose:
- To evaluate the safety and efficacy of the Heartstring proximal anastomotic system.
- To assess the feasibility of creating clampless, hand-sewn proximal anastomoses.
- To determine the impact of the device on graft patency and neurological outcomes.
Summary:
- The Heartstring system was used for 40 proximal anastomoses in 34 patients undergoing coronary artery revascularization (31 off-pump, 3 on-pump).
- High saphenous vein graft patency (97.5%) was observed, with one graft occlusion unrelated to the device.
- The study reported a low incidence of postoperative stroke and one mortality due to non-anastomotic causes.
Impact:
- The Heartstring system facilitates clampless, reproducible hand-sewn proximal anastomoses.
- It may reduce the incidence of neurological complications in coronary artery bypass grafting.
- This device offers a promising alternative for proximal anastomosis in specific cardiac surgical procedures.
Abstract:
The Heartstring proximal anastomotic system is a device designed to facilitate the creation of a clampless hand-sewn proximal anastomosis. Thirty-four patients who underwent coronary artery revascularization had 40 proximal anastomoses using the Heartstring device. There were 26 men and 8 women, with the mean age of 70 +/- 8.9 years. Thirty-one patients underwent coronary artery bypass grafting through off-pump procedures and 3 patients on-pump beating procedures. In all patients, saphenous vein grafts were anastomosed to the aorta using the Heartstring device, the median number of distal anastomoses being 2.4 +/- 0.7. Either emergent or urgent surgery was required in 14 patients (41%). Diseased aorta was found in 11 patients (32%). One patient (2.9%) died postoperatively due to ischemic necrosis of the small intestine and the colon. There was no occurrence of postoperative stroke. Of 40 saphenous vein grafts anastomosed with the Heartstring system, 39 (97.5%) were patent. The occluded saphenous vein was not considered to be device related. Our clinical experience demonstrated that the Heartstring system allow us to create clampless and reproductive hand-sewn proximal anastomosis and to decrease the incidence of neurological complication.
