PMID: 9527199Apr 4, 1998Paper

Intima-adventitia apposition in end-to-side arterial anastomosis: an experimental study in the pig

The Annals of Thoracic Surgery
R H HeijmenC Borst

Abstract

To prevent ischemic complications during coronary bypass grafting on the beating heart, a nonocclusive distal anastomosis technique is needed. One recently developed nonocclusive technique requires apposition of the intima of the graft to the adventitia of the recipient artery, in contrast to current surgical practice, which dictates apposition of both intimas. To compare the sole effect of intima-adventitia apposition (n = 18) versus traditional intima-intima apposition (n = 18), we investigated radiolabeled platelet deposition and histomorphologic aspects of vascular wall healing quantitatively in a porcine carotid artery bypass graft model. Both groups were evaluated at 2 hours, 2 days, or 4 weeks. Within the first 2 hours, 3 of 6 pigs with intima-adventitia apposition exhibited cyclic flow reductions as a result of massive mural thrombosis. After intima-adventitia apposition, the number of deposited platelets was significantly higher compared with intima-intima apposition, 147.1 +/- 73.0 x 10(6) and 4.6 +/- 1.0 x 10(6) platelets/cm2 (mean +/- standard error of the mean), respectively (p = 0.03). At 2 days, the suture line was covered with small mural thrombi, whereas no thrombi were found after intima-intima apposition. At ...Continue Reading

References

Jun 1, 1992·Journal of the American College of Cardiology·T G van LeeuwenC Borst
Jun 1, 1991·Journal of Cardiac Surgery·S BasuI J Jacobowitz
Jan 1, 1995·Acta neurochirurgica·C A Tulleken, R M Verdaasdonk
Feb 1, 1994·The Journal of Clinical Investigation·G H van ZantenJ J Sixma
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Citations

May 16, 1998·The Annals of Thoracic Surgery·R H HeijmenC W Verlaan
Sep 2, 1998·The Annals of Thoracic Surgery·R H HeijmenP F Gründeman
Dec 18, 2002·ANZ Journal of Surgery·Wayne J HawthorneJohn P Fletcher
Nov 3, 2000·Current Cardiology Reports·J S Scheltes, C Borst
Dec 31, 1998·The Journal of Thoracic and Cardiovascular Surgery·R H HeijmenP F Gründeman
Jul 14, 2012·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Bartosz RylskiFriedhelm Beyersdorf

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