Single Heartstring aortotomy for multiple off-pump venous bypass grafts

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.