Assessment of patented coronary end-to-side anastomotic devices using micromechanical bonding

Scheltes, Jules S.; Heikens, Martijn; Pistecky, Peter V.; Andel, Carolien J. van; Borst, Cornelius

doi:10.1016/s0003-4975(00)01380-1

Cited by 27 publications

(15 citation statements)

References 9 publications

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“…Using an anvil, however, creates excessive strain in both the graft and the recipient artery (especially in small arteries) [2]. In addition the view on the operational site (arteriotomy rim and distal end of the graft) is blocked by the bulky application tool (anvil-cartridge-driver component is unavoidably large).…”

Section: Simultaneous Application Of Bonding Elementsmentioning

confidence: 99%

“…In most cases the distal end of the graft as well as the arteriotomy are widened or totally everted. Everting an artery might cause damage to the intimal layer due to occurrence of large stresses in the arterial wall [2], and may create an artificial stenosis (lifting of the bottom of the anastomosis).…”

Section: One-component Framementioning

confidence: 99%

“…In the past decades almost 60 ideas for vascular anastomotic devices have been described in the (patent) literature [1,2]. Most ideas are anastomotic devices using micromechanical fastening techniques [2].…”

Section: Introductionmentioning

confidence: 99%

“…Most ideas are anastomotic devices using micromechanical fastening techniques [2]. Other ideas describe facilitating the construction of an anastomosis using laserassisted vascular anastomosis techniques or adhesive bonding of donor and recipient vessel [1].…”

Section: Introductionmentioning

confidence: 99%

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Coronary anastomotic devices: Theory and patented ideas on micromechanical fastening

Scheltes

Borst

2000

Curr Cardiol Rep

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Coronary anastomotic devices are being designed to reduce the laborious, complex suturing approach to endoscopic coronary surgery. An anastomotic device should be safe and reliable, it should allow full view of the vessel parts to be bonded, it must provide a simple and rapid deployment, and should be hemodynamically adequate. Three anastomotic device categories found in the (patent) literature are discussed that use micromechanical fastening techniques. First, devices using individual bonding elements; second, devices using bonding elements anchored to extra-luminal frames; third, devices using an internal frame, often a stent-like structure. Anastomotic devices described in the (patent) literature to date fail to meet all requirements for endoscopic coronary application.

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Section: Simultaneous Application Of Bonding Elementsmentioning

confidence: 99%

Section: One-component Framementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Coronary anastomotic devices: Theory and patented ideas on micromechanical fastening

Scheltes

Borst

2000

Curr Cardiol Rep

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“…These developments will require new techniques for coronary artery bypass grafting because of limited access and space. Many patents of facilitated anastomotic techniques show the use of anvils and other microstructures [2]. Applying such techniques often causes extreme deformations in the arterial wall of both donor and recipient vessel and this could lead to severe damage of arterial wall structures.…”

mentioning

confidence: 99%

Mechanical properties of coronary arteries and internal mammary arteries beyond physiological deformations

Andel

Pistecky

Borst³

2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Abstract-Passive circumferential and axial mechanical properties of porcine coronary arteries and internal mammary arteries (IMA) were measured and compared. The cylindrical specimens were subjected to axial stretch and internal pressures up to 300 mmHg. Stress-strain relations of the arteries were calculated from the measured data and compared. It was found that the stresses in the IMA were much higher and that the IMA is stiffer than the coronary artery, especially in the circumferential direction. The axial stress in the coronary artery increased substantially after axial stretching, this in contrast to the axial stress in the IMA. Keywords-coronary artery, internal mammary artery, stress, strain, bypass I. INTRODUCTIONCoronary artery bypass surgery is changing recently. Surgery on the beating heart with local mechanical stabilizers is practiced in 15-20 % of the cases worldwide. Telemanipulation systems are introduced that allow surgeons to explore minimally invasive coronary surgery [1]. These developments will require new techniques for coronary artery bypass grafting because of limited access and space. Many patents of facilitated anastomotic techniques show the use of anvils and other microstructures [2]. Applying such techniques often causes extreme deformations in the arterial wall of both donor and recipient vessel and this could lead to severe damage of arterial wall structures. These extreme deformations can initiate intimal hyperplasia, which could eventually lead to stenosis of the anastomosis. Therefore it is important to know more about the mechanical properties of arteries involved in coronary artery bypass surgery. We investigated the main coronary arteries and a graft, the IMA, because of its good clinical results [3]. II. METHODOLOGYFor this study the vessels of 13 healthy Landrace pigs (weight 70-90 kg) were used. The animals were sacrificed in the course of other experiments. A total of 8 cylindrical segments of coronary arteries and 6 segments of the IMA were harvested. All arteries were measured within 24 hours after termination. The coronary arteries were removed from the hearts, all side branches were carefully closed with small clips. Surrounding tissue and loose adventitial fibers were removed. The mechanical properties were measured by subjecting the arterial segments to inflation and axial tension in an experimental setup. Both ends of each arterial segment were connected to metallic cannulae with sutures. The cannulae were connected to a tensile testing machine with which both the axial lengthening of the segment could be regulated and the axial force was measured. In general, a segment of a vessel shortens after removal from the surrounding tissue. To approximate their original length, the arteries were given pre-stretches in the axial direction. The upper cannula was closed and the lower cannula was connected to a reservoir with Tyrode solution (in mM: NaCl 140; KCl 4.9; MgSO 4 1.2; NaH 2 PO 4 1.8 and Hepes 5). The cannulated segment was placed in a small chamber with parallel g...

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Key issues in sutureless vascular anastomoses

Sutureless Anastomoses

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Assessment of patented coronary end-to-side anastomotic devices using micromechanical bonding

Cited by 27 publications

References 9 publications

Coronary anastomotic devices: Theory and patented ideas on micromechanical fastening

Coronary anastomotic devices: Theory and patented ideas on micromechanical fastening

Mechanical properties of coronary arteries and internal mammary arteries beyond physiological deformations

Key issues in sutureless vascular anastomoses

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