A new nonocclusive laser-assisted coronary anastomotic connector in a rabbit model.

Journal of Thoracic and Cardiovascular Surgery, 2012

[Epub ahead of print] A new nonocclusive laser-assisted coronary anastomotic connector in a rabbit model.
Abstract OBJECTIVE: The Excimer laser-assisted nonocclusive anastomotic technique is a nonocclusive, facilitated bypass technique that is currently Conformité Européenne and Food and Drug Administration approved for clinical application in neurosurgery.
In the present study, we assessed the safety and feasibility of a newly developed Excimer laser-assisted nonocclusive anastomosis-based prototype coronary anastomotic connector in an acute rabbit abdominal aortic bypass model before application in experimental coronary bypass surgery.
In addition, 2 sealants were tested to facilitate anastomotic hemostasis in the current device prototype.
METHODS: A total of 40 anastomoses were constructed on the abdominal aorta (3.5 mm outer diameter) of 10 rabbits.
The anastomotic circumference was sealed by a surgical sealant to obtain complete hemostasis (BioGlue vs TachoSil).
The anastomoses were evaluated by flow measurements construction time, hemostasis, histologic analysis, and burst pressure testing.
RESULTS: The connector enabled a nonocclusive and fast (6.0 ± 1.7 minutes, mean ± SD [including sealing]) anastomosis construction and complete hemostasis in 95% (35/37).
Despite technical imperfections (7/40 failures to completely retrieve the flap by the laser), all 40 anastomoses were patent, showed reproducible construction with intima-adventitia apposition, streamlining thrombus coverage of the intraluminal laser rim, and no vessel wall damage.
CONCLUSIONS: The results of the present study have demonstrated that the Excimer laser-assisted nonocclusive anastomotic connector is safe and reliable and can be efficiently applied in an acute rabbit abdominal aortic bypass model.