Clinical Experience with the CorLink Device for Proximal Anastomosis of the Saphenous Vein to the Aorta: A Clinical, Prospective, and Randomized Study

(#2002-71002 ... September 25, 2002)

Friedrich-Christian Riess, MD,¹ Hanns Helmold, MD,¹ Irene Hilfer, MD,¹ Ralf Bader, MD,¹ Jan Stripling, MD,¹ Christine Loewer, MD,² Frank Wesner, MD,³ Niels Bleese, MD¹

Departments of ¹Cardiac Surgery and ²Cardiac Anesthesia, Albertinen-Krankenhaus; ³Praxis Fleethof, Hamburg, Germany

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ABSTRACT

Background: Avoiding tangential clamping of the ascending aorta during coronary bypass operations reduces the trauma to the aorta and may avoid local particulate embolization.

Methods: From December 2000 to May 2001, 21 male patients, mean age 64.1 ± 7.2 years (range, 46-76 years), with coronary artery 2-vessel (n = 3) and 3-vessel (n = 18) disease were divided randomly into 2 groups and underwent myocardial revascularization. In 11 patients an aorta-saphenous vein graft anastomosis was performed with the CorLink device for anastomosis between the saphenous vein and the ascending aorta. Ten patients served as control subjects. In these patients the central bypass anastomosis was performed with a 6-0 running suture. Clinical follow-up was performed 1 month and 3 months postoperatively. Six months after surgery, multislice computed tomography was performed to evaluate bypass patency for all patients.

Results: Mean number of study vessels was 1.2 ± 0.4 in the CorLink group and 1.5 ± 0.5 in the control group. In the CorLink group, 13 additional arterial and vein grafts were performed, and in the suture control group 15 additional mammary artery grafts were carried out. No intraoperative complications occurred. In 2 CorLink anastomoses an additional stitch was necessary because of minor bleeding. Follow-up was carried out at 6 months with multislice computed tomography for all patients and showed only 1 study vessel occlusion in the CorLink group. All 62 other bypass grafts were revealed to be patent and had anastomoses of good quality.

Conclusion: Our experience suggests that the CorLink device is a safe and effective technique for anastomosis between saphenous vein grafts and the ascending aorta. The CorLink device could be used for totally endoscopic coronary bypass operations. Further randomized studies enrolling a larger number of patients are necessary to determine which patients may benefit the most from this procedure.

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