A Technique to Make Multiple Proximal Anastomoses with One HEARTSTRING Suture Device

Tokunaga, Shigehiko; Tominaga, Norihisa; Lee, Sang-Hun; Masuda, Munetaka

doi:10.1111/jocs.12706

Cited by 2 publications

(1 citation statement)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As a strategy to prevent the perioperative stroke, two proximal anastomoses, as a composite graft, can be made with one Heartstring device. [22][23][24] As shown in ►Video 1, we increasingly use this technique to further reduce aortic manipulation. A composite graft is preferable not only for SVG but also for arterial conduits.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of 881 Consecutive Coronary Artery Bypass Graft Patients Using Heartstring Device

Amano,

Takami,

Maekawa

et al. 2024

Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Backgrounds One of the strategies to prevent stroke after coronary artery bypass grafting (CABG) may be the use of a device for proximal anastomosis without partial clamp of the ascending aorta. Methods We retrospectively investigated early and late outcomes in consecutive 881 patients undergoing isolated CABG using Heartstring for proximal anastomosis from January 2008 to December 2022, to reveal the validity to use it. All patients underwent preoperative imaging workups to evaluate neurovascular atherosclerosis. Results The mean age of the patients was 68.9 years, 20% were female and 13% had previous history of stroke. CABG was on-pump beating heart (52.2%) or off-pump (47.8%) with a mean number of distal anastomoses of 3.38 ± 0.93, using 1.62 ± 0.53 Heartstring devices under different aortic manipulations. In-hospital mortality was 2.0% and perioperative stroke rate was 0.9%, none of them died during hospital stay. During the follow-up period of 70 ± 47 months, the overall actuarial survival rates were 86 and 66%, and major adverse cardiac and cerebrovascular events (MACCEs)-free rates were 86 and 70% at 5 and 10 years, respectively. On multivariable analysis, risk factors for late death included male, previous history of stroke, postoperative sternomediastinitis, late new-onset stroke, and MACCEs, but did not include the perioperative stroke. Conclusion Low stroke rate, as low as 0.9%, after CABG using Heartstring for proximal anastomosis, although under a variety of aortic manipulations, may contribute to the improved long-term prognosis.

show abstract

Section: Discussionmentioning

confidence: 99%