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Updated: Jun 18, 2026
Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
Robotic hand-sewn anastomosis versus anastomotic connector in beating-heart totally endoscopic coronary artery
Hiroto Kitahara1, Sarah Nisivaco1, Brooke Patel1
1Department of Surgery, Section of Cardiac Surgery, The University of Chicago Medicine, Chicago, Ill.
Objective:
To compare the outcomes of a robotic hand-sewn anastomosis versus a distal coronary anastomotic connector in single-vessel robotic beating-heart totally endoscopic coronary artery bypass (TECAB).
Methods:
Of a total 811 patients undergoing robotic TECAB between July 2013 and September 2023, 301 consecutive patients (37%) who underwent left internal thoracic artery to the left anterior descending artery bypass were included in this study. The anastomotic connector was used in 129 patients and robotic hand-sewn in 172 patients. Propensity matching identified 100 matched pairs of anastomotic connector (group 1) and hand-sewn (group 2) for analysis. The intraoperative and postoperative data were compared.
Results:
After propensity matching, there were no significant differences in baseline characteristics. The median operative time was shorter in group 1 (140 minutes vs 172 minutes, P = .001). Left internal thoracic artery-left anterior descending flow was similar (group 1: 85 mL/min vs group 2: 95 mL/min, P = .164). The length of hospital stay was shorter in the group 2 (2.5 ± 0.9 days, vs 2.0 ± 0.7 days, P = .001). In-hospital mortality was similar between the groups (group 1: 1.0%, vs group 2: 0%, P = 1.000). Freedom from major adverse cardiovascular events at 1 year was 91.8% in group 1 and 96.9% in group 2 (P = .072).
Conclusions:
The use of an anastomotic connector in single-vessel robotic TECAB was associated with shorter operative time. Both anastomotic techniques demonstrated excellent 1-year outcomes.
