The Excimer Laser Assisted Non-Occlusive Anastomosis (ELANA) Anastomotic System Surgical Technique to Construct Distal Anastomoses Using a Novel Device in Coronary Artery Bypass Grafting

In this article, the authors describe the excimer laser assisted non-occlusive anastomosis (ELANA) anastomotic system for coronary artery bypass grafting (CABG), a distal anastomotic connector that enables the construction of a coronary anastomosis on a coronary target vessel. The system uses an ELANA clip, fixation components, applicators, a vacuum pump, and an excimer laser catheter to connect the graft to the coronary artery and excise tissue flaps after clip positioning. The report outlines patient selection requirements, device components, clip size criteria, laser settings, procedural steps, and possible pitfalls such as posterior wall injury, incomplete flap retrieval, or the need for conversion to a sutured anastomosis. An example case was reported in which a left internal thoracic artery to left anterior descending anastomosis was completed in 20 minutes in a 63-year-old man, with satisfactory flow and six-month angiographic patency.