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Single Heartstring aortotomy for multiple off-pump venous bypass grafts.

Lars Niclauss1, Sébastien Colombier2, René Prêtre2

  • 1Department of Cardiovascular Surgery, University Hospital of Lausanne, Lausanne, Switzerland lars.niclauss@chuv.ch.

Asian Cardiovascular & Thoracic Annals
|June 8, 2014
PubMed
Summary

Off-pump coronary artery bypass grafting (CABG) using the Heartstring device for clampless proximal anastomosis may reduce stroke risk. This technique efficiently sutures two venous grafts to a single aortotomy, beneficial for challenging aortic conditions.

Keywords:
Anastomosisaortacoronary artery bypassoff-pumpsaphenous veinsurgicalthoracic

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Anastomosis Techniques
  • Minimally Invasive Cardiac Procedures

Background:

  • Off-pump coronary artery bypass grafting (CABG) minimizes aortic manipulation, potentially reducing stroke incidence.
  • Proximal venous graft anastomosis in off-pump CABG often requires aortic clamping.
  • The Heartstring device facilitates clampless hemostasis during anastomosis.

Purpose of the Study:

  • To describe a novel technique for performing proximal venous anastomoses in off-pump CABG using a single Heartstring device.
  • To evaluate the applicability and benefits of this technique, particularly in aortas with challenging anatomical features.

Main Methods:

  • A technique utilizing the Heartstring device to suture two venous grafts to a single aortotomy is described.
  • This method aims to achieve clampless hemostasis and reduce the space required for anastomosis.
  • The technique is presented in the context of off-pump coronary artery bypass grafting.

Main Results:

  • The described technique allows for the anastomosis of two venous grafts to one aortotomy using a single device.
  • This approach is advantageous in cases of short, small, or calcified aortas.
  • The technique was found to be rapid, simple, easily reproducible, and cost-saving in experienced hands.

Conclusions:

  • A single Heartstring device can be effectively used for dual venous graft anastomosis to a single aortotomy during off-pump CABG.
  • This technique offers a practical solution for challenging aortic anatomies, potentially improving surgical efficiency and outcomes.
  • The method is associated with speed, simplicity, reproducibility, and cost-effectiveness.