ABSTRACT 38

SUTURELESS CORONARY ARTERY BYPASS GRAFTING

Kenton Zehr, M.D. and Hartzell V. Schaff, M.D., Mayo Clinic, Rochester, MN; Luis Bonilla, M.D., William Swanson, M.D., Paul Hindrichs, BSME, Rick Cornelius, BSME, Todd Berg, BSME, St. Jude Medical, Cardiovascular Group, Minneapolis, MN.

Objective: The coronary artery bypass grafting operation has been subjected to an explosion of new ideas and technology.  These have included grafting without the use of cardiopulmonary bypass using stabilizers, shunts, and positioning techniques, computer assisted robotic techniques, and various alternatives to suture.  Our vision for the future includes the ability to place a graft rapidly and flawlessly with a no clamp technique.

Methods: Stainless steel connectors have been developed to establish both proximal and distal anastomoses. We present a near real-time video showing placement of two grafts in a porcine model using this novel approach.  The graft is loaded pre-operatively onto the connector and placed via a small aortotomy and coronary arteriotomy.  The anastomosis is established by balloon expansion of the connector into the engaged position. 

Results: Two saphenous vein graft bypasses are successfully placed from the aorta to the left anterior descending and to the circumflex coronary arteries under cardiopulmonary bypass and ventricular fibrillatory arrest. 

Conclusions: This successful sutureless coronary artery bypass grafting operation reveals significant possibilities for the future conduct of coronary revascularization procedures.