Progress in cardiovascular anastomoses: will the vascular join replace Carrel's technique?

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Serval ID
serval:BIB_6A6077A15C65
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Progress in cardiovascular anastomoses: will the vascular join replace Carrel's technique?
Journal
European Journal of Cardio-thoracic Surgery
Author(s)
Tozzi P., Borghi E., Haesler E., Siniscalchi G., Motti A., Hayoz D., von Segesser L.K.
ISSN
1010-7940
Publication state
Published
Issued date
2006
Peer-reviewed
Oui
Volume
30
Number
3
Pages
425-430
Language
english
Abstract
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.
Keywords
Anastomosis, Surgical, Animals, Cardiovascular Diseases, Carotid Arteries, Equipment Design, Regional Blood Flow, Sheep, Sutures, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
29/01/2008 9:56
Last modification date
25/09/2019 7:09
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