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Experimental Model for Sutureless Proximal Anastomosis by the Viabahn Open Revascularization TEChnique (VORTEC)

INTRODUCTION: In the treatment of complex aneurysms, debranching is an extra-anatomical revascularization of visceral arteries followed by endograft coverage of the thoracoabdominal aorta. It eliminates the need for a thoracotomy and aortic clamping, but requires the performance of several technical...

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Autores principales: Freire, Lucas Marcelo Dias, Gobbi, Giuliana Biasi, Fabbro, Inácio Maria Dal, Menezes, Fábio Hüsemann
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Cirurgia Cardiovascular 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407145/
https://www.ncbi.nlm.nih.gov/pubmed/28076621
http://dx.doi.org/10.5935/1678-9741.20160087
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author Freire, Lucas Marcelo Dias
Gobbi, Giuliana Biasi
Fabbro, Inácio Maria Dal
Menezes, Fábio Hüsemann
author_facet Freire, Lucas Marcelo Dias
Gobbi, Giuliana Biasi
Fabbro, Inácio Maria Dal
Menezes, Fábio Hüsemann
author_sort Freire, Lucas Marcelo Dias
collection PubMed
description INTRODUCTION: In the treatment of complex aneurysms, debranching is an extra-anatomical revascularization of visceral arteries followed by endograft coverage of the thoracoabdominal aorta. It eliminates the need for a thoracotomy and aortic clamping, but requires the performance of several technically demanding visceral anastomosis. In 2008, Lachat described visceral revascularization with the use of a sutureless distal anastomosis, performed by the telescoping of an endograft in the visceral branch, named VORTEC (Viabahn Open Revascularization TEChnique). OBJECTIVE: An experimental model was created to test the feasibility and short term results of performing a telescoped proximal anastomosis to the abdominal aorta. METHODS: Swine model. The abdominal aorta was dissected and ligated between the renal arteries and the iliac vessels. Three centimeters bellow the renal arteries a Viabahn endograft was telescoped for 2 cm into the proximal aorta. The other extremity was conventionally anastomosed to the distal aorta. Patency, sealing and tensile strength of the anastomosis were tested. RESULTS: Time for performing the telescoped anastomosis was shorter (5.4±2.8 min versus 10.3±3.4 min, P<0.05). All grafts were patent and both types of anastomosis presented no bleeding. Immediate tensile strength showed a higher strength of the conventional suture (22.7 x 14.3 N, P<0.09). After 30 days there was no pseudo-aneurysms and the strength of the conventional and VORTEC anastomosis were similar (37.3 x 40.8 N, respectively, P=0.17). CONCLUSION: Telescoped proximal anastomosis by the technique of VORTEC is feasible. After 30 days the tensile strength of the both anastomosis were similar.
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spelling pubmed-54071452017-05-01 Experimental Model for Sutureless Proximal Anastomosis by the Viabahn Open Revascularization TEChnique (VORTEC) Freire, Lucas Marcelo Dias Gobbi, Giuliana Biasi Fabbro, Inácio Maria Dal Menezes, Fábio Hüsemann Braz J Cardiovasc Surg Original Articles INTRODUCTION: In the treatment of complex aneurysms, debranching is an extra-anatomical revascularization of visceral arteries followed by endograft coverage of the thoracoabdominal aorta. It eliminates the need for a thoracotomy and aortic clamping, but requires the performance of several technically demanding visceral anastomosis. In 2008, Lachat described visceral revascularization with the use of a sutureless distal anastomosis, performed by the telescoping of an endograft in the visceral branch, named VORTEC (Viabahn Open Revascularization TEChnique). OBJECTIVE: An experimental model was created to test the feasibility and short term results of performing a telescoped proximal anastomosis to the abdominal aorta. METHODS: Swine model. The abdominal aorta was dissected and ligated between the renal arteries and the iliac vessels. Three centimeters bellow the renal arteries a Viabahn endograft was telescoped for 2 cm into the proximal aorta. The other extremity was conventionally anastomosed to the distal aorta. Patency, sealing and tensile strength of the anastomosis were tested. RESULTS: Time for performing the telescoped anastomosis was shorter (5.4±2.8 min versus 10.3±3.4 min, P<0.05). All grafts were patent and both types of anastomosis presented no bleeding. Immediate tensile strength showed a higher strength of the conventional suture (22.7 x 14.3 N, P<0.09). After 30 days there was no pseudo-aneurysms and the strength of the conventional and VORTEC anastomosis were similar (37.3 x 40.8 N, respectively, P=0.17). CONCLUSION: Telescoped proximal anastomosis by the technique of VORTEC is feasible. After 30 days the tensile strength of the both anastomosis were similar. Sociedade Brasileira de Cirurgia Cardiovascular 2016 /pmc/articles/PMC5407145/ /pubmed/28076621 http://dx.doi.org/10.5935/1678-9741.20160087 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Freire, Lucas Marcelo Dias
Gobbi, Giuliana Biasi
Fabbro, Inácio Maria Dal
Menezes, Fábio Hüsemann
Experimental Model for Sutureless Proximal Anastomosis by the Viabahn Open Revascularization TEChnique (VORTEC)
title Experimental Model for Sutureless Proximal Anastomosis by the Viabahn Open Revascularization TEChnique (VORTEC)
title_full Experimental Model for Sutureless Proximal Anastomosis by the Viabahn Open Revascularization TEChnique (VORTEC)
title_fullStr Experimental Model for Sutureless Proximal Anastomosis by the Viabahn Open Revascularization TEChnique (VORTEC)
title_full_unstemmed Experimental Model for Sutureless Proximal Anastomosis by the Viabahn Open Revascularization TEChnique (VORTEC)
title_short Experimental Model for Sutureless Proximal Anastomosis by the Viabahn Open Revascularization TEChnique (VORTEC)
title_sort experimental model for sutureless proximal anastomosis by the viabahn open revascularization technique (vortec)
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407145/
https://www.ncbi.nlm.nih.gov/pubmed/28076621
http://dx.doi.org/10.5935/1678-9741.20160087
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