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Preclinical Feasibility and Patency Analyses of a New Distal Coronary Connector: The ELANA Heart Bypass
OBJECTIVE: This preclinical study determines the feasibility and 6-month patency rates of a new distal coronary connector, the Excimer Laser Assisted Nonocclusive Anastomosis (ELANA) Heart Bypass. METHODS: Twenty Dutch Landrace pigs received either a hand-sewn (n = 8) or an ELANA (n = 12) left inter...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8108114/ https://www.ncbi.nlm.nih.gov/pubmed/33682510 http://dx.doi.org/10.1177/1556984521991519 |
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author | Stecher, David Hoogewerf, Marieke Bronkers, Glenn van Putte, Bart P. Doevendans, Pieter A. Tulleken, Cornelis A.F. van Herwerden, Lex Pasterkamp, Gerard Buijsrogge, Marc P. |
author_facet | Stecher, David Hoogewerf, Marieke Bronkers, Glenn van Putte, Bart P. Doevendans, Pieter A. Tulleken, Cornelis A.F. van Herwerden, Lex Pasterkamp, Gerard Buijsrogge, Marc P. |
author_sort | Stecher, David |
collection | PubMed |
description | OBJECTIVE: This preclinical study determines the feasibility and 6-month patency rates of a new distal coronary connector, the Excimer Laser Assisted Nonocclusive Anastomosis (ELANA) Heart Bypass. METHODS: Twenty Dutch Landrace pigs received either a hand-sewn (n = 8) or an ELANA (n = 12) left internal thoracic artery to left anterior descending artery anastomosis, using off-pump coronary artery bypass grafting. Six-month patency rates were demonstrated by coronary angiography and histological evaluation. Throughout, procedural details and complication rates were collected. RESULTS: The ELANA Heart Bypass demonstrated 0% mortality and complication rates during follow-up. It was demonstrated feasible, with comparable perioperative flow measurements (ELANA vs hand-sewn, median [min to max], 24 [14 to 28] vs 17 [12 to 31] mL/min; P = 0.601) and fast construction times (3 [3 to 7] vs 31 [26 to 37] min; P < 0.001). Yet, an extra hemostatic stitch was needed in 25% of the ELANA versus 12.5% of the hand-sewn anastomoses. The 6-month patency rate of the ELANA Heart Bypass was 83.3% versus 100% in hand-sewn anastomoses. The 2 occluded ELANA-anastomoses were defined model-based errors. CONCLUSIONS: The ELANA Heart Bypass facilitates a sutureless distal coronary anastomosis. A design change is suggested to improve hemostasis and will be evaluated in future translational studies. This new technique is a potential alternative to hand-sewn anastomoses in (minimally invasive) coronary surgery. |
format | Online Article Text |
id | pubmed-8108114 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-81081142021-05-17 Preclinical Feasibility and Patency Analyses of a New Distal Coronary Connector: The ELANA Heart Bypass Stecher, David Hoogewerf, Marieke Bronkers, Glenn van Putte, Bart P. Doevendans, Pieter A. Tulleken, Cornelis A.F. van Herwerden, Lex Pasterkamp, Gerard Buijsrogge, Marc P. Innovations (Phila) Original Articles OBJECTIVE: This preclinical study determines the feasibility and 6-month patency rates of a new distal coronary connector, the Excimer Laser Assisted Nonocclusive Anastomosis (ELANA) Heart Bypass. METHODS: Twenty Dutch Landrace pigs received either a hand-sewn (n = 8) or an ELANA (n = 12) left internal thoracic artery to left anterior descending artery anastomosis, using off-pump coronary artery bypass grafting. Six-month patency rates were demonstrated by coronary angiography and histological evaluation. Throughout, procedural details and complication rates were collected. RESULTS: The ELANA Heart Bypass demonstrated 0% mortality and complication rates during follow-up. It was demonstrated feasible, with comparable perioperative flow measurements (ELANA vs hand-sewn, median [min to max], 24 [14 to 28] vs 17 [12 to 31] mL/min; P = 0.601) and fast construction times (3 [3 to 7] vs 31 [26 to 37] min; P < 0.001). Yet, an extra hemostatic stitch was needed in 25% of the ELANA versus 12.5% of the hand-sewn anastomoses. The 6-month patency rate of the ELANA Heart Bypass was 83.3% versus 100% in hand-sewn anastomoses. The 2 occluded ELANA-anastomoses were defined model-based errors. CONCLUSIONS: The ELANA Heart Bypass facilitates a sutureless distal coronary anastomosis. A design change is suggested to improve hemostasis and will be evaluated in future translational studies. This new technique is a potential alternative to hand-sewn anastomoses in (minimally invasive) coronary surgery. SAGE Publications 2021-03-07 2021-03 /pmc/articles/PMC8108114/ /pubmed/33682510 http://dx.doi.org/10.1177/1556984521991519 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Articles Stecher, David Hoogewerf, Marieke Bronkers, Glenn van Putte, Bart P. Doevendans, Pieter A. Tulleken, Cornelis A.F. van Herwerden, Lex Pasterkamp, Gerard Buijsrogge, Marc P. Preclinical Feasibility and Patency Analyses of a New Distal Coronary Connector: The ELANA Heart Bypass |
title | Preclinical Feasibility and Patency Analyses of a New Distal Coronary Connector: The ELANA Heart Bypass |
title_full | Preclinical Feasibility and Patency Analyses of a New Distal Coronary Connector: The ELANA Heart Bypass |
title_fullStr | Preclinical Feasibility and Patency Analyses of a New Distal Coronary Connector: The ELANA Heart Bypass |
title_full_unstemmed | Preclinical Feasibility and Patency Analyses of a New Distal Coronary Connector: The ELANA Heart Bypass |
title_short | Preclinical Feasibility and Patency Analyses of a New Distal Coronary Connector: The ELANA Heart Bypass |
title_sort | preclinical feasibility and patency analyses of a new distal coronary connector: the elana heart bypass |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8108114/ https://www.ncbi.nlm.nih.gov/pubmed/33682510 http://dx.doi.org/10.1177/1556984521991519 |
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