The nonocclusive laser-assisted coronary anastomotic connector in an off-pump porcine bypass model

Stecher, David; Slochteren, Frebus J. van; Hoefer, Imo E.; Pasterkamp, Gérard; Tulleken, Cornelis A.F.; Herwerden, Lex A. van; Buijsrogge, Marc P.

doi:10.1016/j.jtcvs.2013.07.018

Cited by 11 publications

(14 citation statements)

References 11 publications

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“…C = connector; RITA = right internal thoracic artery; RCA = right coronary artery. (B) A detailed SEM image at the level of the fork of the connector demonstrating complete coverage with endothelium (2,080X magnification), at 6-month followup 6,7 .…”

Section: Representative Resultsmentioning

confidence: 99%

“…Moreover, in a porcine open sternotomy OPCAB model, proper healing with minimal intimal hyperplasia was found at the long-term 6,7 . dissection of the coronary artery, in such a way a hemoclip can completely ligate the coronary artery.…”

Section: Introductionmentioning

confidence: 89%

“…6. Then evaluate the intravascular anastomotic surface (i.e., assessment of endothelial and/or thrombocyte coverage) using a scanning electron microscope 6 .…”

Section: Optional: Intraoperative Coronary Angiographymentioning

confidence: 99%

“…To simplify and facilitate beating heart (i.e., off-pump), minimally invasive coronary artery bypass surgery, a new coronary anastomotic connector is developed: the Trinity Clip 3,4 , based on the excimer laser-assisted nonocclusive anastomosis (ELANA) technique [5][6][7][8][9] . The connector enables simplified, sutureless, and nonocclusive connection of the graft to the coronary artery, and an excimer laser catheter laser-punches the opening of the anastomosis.…”

Section: Introductionmentioning

confidence: 99%

“…Once the drains stop producing, remove the drains. 5,6 ), and note if extra stitches are needed to obtain hemostasis.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model

Stecher¹,

Bronkers²,

Noest³

et al. 2014

JoVE

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To simplify and facilitate beating heart (i.e., off-pump), minimally invasive coronary artery bypass surgery, a new coronary anastomotic connector, the Trinity Clip, is developed based on the excimer laser-assisted nonocclusive anastomosis technique. The Trinity Clip connector enables simplified, sutureless, and nonocclusive connection of the graft to the coronary artery, and an excimer laser catheter laser-punches the opening of the anastomosis. Consequently, owing to the complete nonocclusive anastomosis construction, coronary conditioning (i.e., occluding or shunting) is not necessary, in contrast to the conventional anastomotic technique, hence simplifying the off-pump bypass procedure. Prior to clinical application in coronary artery bypass grafting, the safety and quality of this novel connector will be evaluated in a long-term experimental porcine off-pump coronary artery bypass (OPCAB) study. In this paper, we describe how to evaluate the coronary anastomosis in the porcine OPCAB model using various techniques to assess its quality. Representative results are summarized and visually demonstrated.

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Section: Representative Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 89%

“…6. Then evaluate the intravascular anastomotic surface (i.e., assessment of endothelial and/or thrombocyte coverage) using a scanning electron microscope 6 .…”

Section: Optional: Intraoperative Coronary Angiographymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Once the drains stop producing, remove the drains. 5,6 ), and note if extra stitches are needed to obtain hemostasis.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model

Stecher¹,

Bronkers²,

Noest³

et al. 2014

JoVE

Self Cite

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Anastomotic Devices for Coronary Artery Surgery

Patel

Hemli

2020

Cardiac Surgery

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The Sutureless Excimer Laser Anastomosis Clip Pilot Study: a feasibility and safety study

Zwan

Gortzak²,

Boer³

et al. 2022

Acta Neurochir

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Background The excimer laser-assisted non-occlusive anastomosis (ELANA) bypass technique may have the advantage of its non-occlusive design in the treatment of last-resort cases where endovascular treatment or direct clipping is considered to be unsafe. However, the technique remains technically challenging. Therefore, a sutureless ELANA Clip device (SEcl) was developed to simplify the technique avoiding tedious anastomosis stitching in depth. The present study investigates the clinical feasibility and safety of the SEcl technique. Methods Three patients with complex and large aneurysms in the anterior circulation were selected after multidisciplinary consensus that the aneurysms were too complex for endovascular or direct clipping treatment options. Bypass surgery was considered as a last-resort treatment option, and after preoperative evaluation and informed consent, SEcl bypass surgery was performed. Applicability, technical aspects and patient outcomes are assessed. Results All aneurysms were excluded from the circulation. The creation of the intracranial anastomosis was easier and faster. No device-related serious adverse events were encountered, and all outcomes were favorable (one patient stable Modified Rankin Scale, two patients improved). Conclusion The SEcl anastomosis technique is feasible and, considering the severity of the disease, relatively safe. It can be considered a treatment option in very difficult-to treat last-resort aneurysm cases. From this study, further developments in minimizing clip size and application in cardiac surgery are initiated.

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The nonocclusive laser-assisted coronary anastomotic connector in an off-pump porcine bypass model

Cited by 11 publications

References 11 publications

Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model

Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model

Anastomotic Devices for Coronary Artery Surgery

The Sutureless Excimer Laser Anastomosis Clip Pilot Study: a feasibility and safety study

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