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Article: Nonpenetrating stapling: A valuable alternative for coronary anastomoses?

TitleNonpenetrating stapling: A valuable alternative for coronary anastomoses?
Authors
Issue Date1998
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsur
Citation
Annals Of Thoracic Surgery, 1998, v. 66 n. 5, p. 1705-1708 How to Cite?
AbstractBackground. The safe development of minimally invasive coronary artery bypass operations might require alternatives to conventional suture-based anastomotic techniques. In this setting, nonpenetrating stapling is an attractive option because of its simplicity of use and potential for improved endothelial preservation. Methods and Results. In the experimental part of this study, porcine internal mammary arteries were anastomosed to left anterior descending coronary arteries using either an 8-0 polypropylene running suture or nonpenetrating microclips (7 anastomoses in each group). The endothelium-dependent relaxations to bradykinin of the arterial rings bearing the anastomosis and of noninstrumented rings were compared in organ chamber experiments. There were no significant differences in maximal relaxations (mean ± SEM) between the microclipped and sutured anastomoses (81% ± 7% versus 74% ± 10%), which were both significantly lower than those of control coronary rings (98% ± 2%, p = 0.001 versus the two anastomosed groups). Histologic examination showed a comparable preservation of the coronary and graft endothelium with both techniques. The clinical part of the study comprised 7 patients in whom the left internal mammary artery was conventionally sutured to the left anterior descending whereas 13 saphenous vein grafts were anastomosed to their target vessels by nonpenetrating staples. There were no clip-related complications. An angiographic assessment of the venous grafts was performed within 10 days postoperatively in all patients. One graft is presumably occluded. The 12 remaining conduits were patent with stapled anastomoses featuring a widely open 'shark-mouth' configuration. Conclusions. These preliminary data suggest that nonpenetrating stapling is an easy-to-use technique that competes well with conventional suturing, at least in terms of immediate results. Further studies are warranted to better define its potential place within the armamentarium of minimally invasive coronary artery bypass techniques.
Persistent Identifierhttp://hdl.handle.net/10722/171214
ISSN
2015 Impact Factor: 2.975
2015 SCImago Journal Rankings: 1.490
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLisi, Gen_US
dc.contributor.authorPerrault, LPen_US
dc.contributor.authorMenasché, Pen_US
dc.contributor.authorBel, Aen_US
dc.contributor.authorWassef, Men_US
dc.contributor.authorVilaine, JPen_US
dc.contributor.authorVanhoutte, PMen_US
dc.date.accessioned2012-10-30T06:12:44Z-
dc.date.available2012-10-30T06:12:44Z-
dc.date.issued1998en_US
dc.identifier.citationAnnals Of Thoracic Surgery, 1998, v. 66 n. 5, p. 1705-1708en_US
dc.identifier.issn0003-4975en_US
dc.identifier.urihttp://hdl.handle.net/10722/171214-
dc.description.abstractBackground. The safe development of minimally invasive coronary artery bypass operations might require alternatives to conventional suture-based anastomotic techniques. In this setting, nonpenetrating stapling is an attractive option because of its simplicity of use and potential for improved endothelial preservation. Methods and Results. In the experimental part of this study, porcine internal mammary arteries were anastomosed to left anterior descending coronary arteries using either an 8-0 polypropylene running suture or nonpenetrating microclips (7 anastomoses in each group). The endothelium-dependent relaxations to bradykinin of the arterial rings bearing the anastomosis and of noninstrumented rings were compared in organ chamber experiments. There were no significant differences in maximal relaxations (mean ± SEM) between the microclipped and sutured anastomoses (81% ± 7% versus 74% ± 10%), which were both significantly lower than those of control coronary rings (98% ± 2%, p = 0.001 versus the two anastomosed groups). Histologic examination showed a comparable preservation of the coronary and graft endothelium with both techniques. The clinical part of the study comprised 7 patients in whom the left internal mammary artery was conventionally sutured to the left anterior descending whereas 13 saphenous vein grafts were anastomosed to their target vessels by nonpenetrating staples. There were no clip-related complications. An angiographic assessment of the venous grafts was performed within 10 days postoperatively in all patients. One graft is presumably occluded. The 12 remaining conduits were patent with stapled anastomoses featuring a widely open 'shark-mouth' configuration. Conclusions. These preliminary data suggest that nonpenetrating stapling is an easy-to-use technique that competes well with conventional suturing, at least in terms of immediate results. Further studies are warranted to better define its potential place within the armamentarium of minimally invasive coronary artery bypass techniques.en_US
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsuren_US
dc.relation.ispartofAnnals of Thoracic Surgeryen_US
dc.subject.meshAgeden_US
dc.subject.meshAnastomosis, Surgical - Methodsen_US
dc.subject.meshAnimalsen_US
dc.subject.meshBradykinin - Pharmacologyen_US
dc.subject.meshCoronary Artery Bypass - Methodsen_US
dc.subject.meshCoronary Vessels - Surgeryen_US
dc.subject.meshEndothelium, Vascular - Physiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshMammary Arteries - Surgeryen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOrgan Culture Techniquesen_US
dc.subject.meshSaphenous Vein - Surgeryen_US
dc.subject.meshSurgical Procedures, Minimally Invasive - Methodsen_US
dc.subject.meshSurgical Stapling - Methodsen_US
dc.subject.meshSwineen_US
dc.titleNonpenetrating stapling: A valuable alternative for coronary anastomoses?en_US
dc.typeArticleen_US
dc.identifier.emailVanhoutte, PM:vanhoutt@hku.hken_US
dc.identifier.authorityVanhoutte, PM=rp00238en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/S0003-4975(98)00912-6en_US
dc.identifier.pmid9875775-
dc.identifier.scopuseid_2-s2.0-0032431137en_US
dc.identifier.volume66en_US
dc.identifier.issue5en_US
dc.identifier.spage1705en_US
dc.identifier.epage1708en_US
dc.identifier.isiWOS:000077703300049-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLisi, G=6701790569en_US
dc.identifier.scopusauthoridPerrault, LP=7004370552en_US
dc.identifier.scopusauthoridMenasché, P=7102635294en_US
dc.identifier.scopusauthoridBel, A=7005839756en_US
dc.identifier.scopusauthoridWassef, M=7006493556en_US
dc.identifier.scopusauthoridVilaine, JP=7004617134en_US
dc.identifier.scopusauthoridVanhoutte, PM=7202304247en_US

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