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ABSTRACT 18
UNCONVENTIONAL INTIMA-ADVENTITIA APPOSITION
AND LOW FLOW IN PORCINE CORONARY BYPASS
Marc Buijsrogge, Paul Grundeman, Cees Verlaan, Cornelius
Borst
Heart-Lung Institute, University Medical Center, Utrecht, the
Netherlands
New designs of distal graft connectors may involve unconventional
vessel wall appositions.
Objective: We assigned the patency after intima-adventitia
apposition (I-A) versus conventional suturing (I-I) in low bypass
graft flow conditions.
Methods: Ligating the mid-LAD in 28 pigs, a low flow distal
RIMA-LAD bypass was created on the beating porcine heart.
By ligation of the left main stem, the circumflex territory was
included in a proximal LIMA-LAD bypass. The anastomoses
were evaluated intra-operatively (n=56) or at 35 days (n=36) by
flow measurements, angiography and histology.
Results: All I-A low flow anastomeses were fully
patent.
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Flow (ml/min)
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Hyperemic response
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Patency
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Intimal
|
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intra-op
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35 days
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intra-op
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35 days
|
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hyperlasia
|
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Low-Flow I-A
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9 ± 3
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12 ± 6
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6.6 ± 1.3
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3.4 ± 2.5
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14/14
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mild
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Low-Flow I-I
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10 ± 2
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14 ± 8
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5.9 ± 1
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3.5 ± 2.4
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13/14
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mild
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Control I-A
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73 ± 13
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59 ± 12
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2.7 ± 0.5
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4.8 ± 1.8
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14/14
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mild
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Control I-I
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55 ± 7
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57 ± 10
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3.2 ± 0.5
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4 ± 1
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14/14
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mild
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Data, mean ± SD
Conculsions: In low flow conditions, intima-adventitia
apposition was not detrimental to the IMA-LAD anastomoses.
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