Document Detail


Progress in cardiovascular anastomoses: will the vascular join replace Carrel's technique?
MedLine Citation:
PMID:  16859919     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Vascular reconstructions are becoming challenging due to the comorbidity of the aging population and since the introduction of minimally invasive approaches. Many sutureless anastomosis devices have been designed to facilitate the cardiovascular surgeon's work and the vascular join (VJ) is one of these. We designed an animal study to assess its reliability and long-term efficacy. METHODS: VJ allows the construction of end-to-end and end-to-side anastomoses. It consists of two metallic crowns fixed to the extremity of the two conduits so that vessel edges are joined layer by layer. There is no foreign material exposed to blood. In adult sheep both carotid arteries were prepared and severed. End-to-end anastomoses were performed using the VJ device on one side and the classical running suture technique on the other side. Animals were followed-up with Duplex-scan every 3 months and sacrificed after 12 months. Histopathological analysis was carried out. RESULTS: In 20 animals all 22 sutureless anastomoses were successfully completed in less than 2 min versus 6 +/- 3 min for running suture. Duplex showed the occlusion of three controls and one sutureless anastomosis. Two controls and one sutureless had stenosis >50%. Histology showed very thin layer of myointimal hyperplasia (50 +/- 10 microm) in the sutureless group versus 300 +/- 27 microm in the control. No significant inflammatory reaction was detected. CONCLUSIONS: VJ provides edge-to-edge vascular repair that can be considered the most physiological way to restore vessel continuity. For the first time, in healthy sheep, an anastomotic device provided better results than suture technique.
Authors:
Piergiorgio Tozzi; Enzo Borghi; Eric Haesler; Giuseppe Siniscalchi; Alessandro Motti; Daniel Hayoz; Ludwig K von Segesser
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-07-20
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  30     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-15     Completed Date:  2006-11-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  425-30     Citation Subset:  IM    
Affiliation:
Cardiovascular Surgery Department, University of Lausanne, CHUV, Lausanne, Switzerland. Piergiorgio.Tozzi@hospvd.ch
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical / instrumentation,  methods
Animals
Cardiovascular Diseases / physiopathology,  surgery
Carotid Arteries / surgery*,  ultrasonography
Equipment Design
Regional Blood Flow / physiology
Sheep
Sutures
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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