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A NEW SUTURING DEVICE FOR SMALL ARTERIES
Ryoichi Kondo1, Yoshifumi Itoda1, Hiroyuki Tsukihara1, Hiroshi Ashiba2, Etsuko Kobayashi2, Ichiro Sakuma2, Minoru Ono1.
1The University of Tokyo, Department of Cardiacsurgery, Tokyo, Japan, 2The University of Tokyo, Department of Precision Engineering, Tokyo, Japan.

OBJECTIVE: We developed a new suturing device that allows far easier performance of minimally invasive coronary artery bypass in comparison with conventional suturing methods. We have already showed no less efficacy and safety of this device than conventional suture in swine OPCAB model. In this experiment, we examined whether this device is superior to conventional suture under endoscopic environment.
METHODS: A total of 18 rabbits were used in this study. The right carotid artery was bypassed using the jugular vein of the same side under endoscopic guidance. Of these, 9 rabbits were operated on using the new devices (Group D) and the other by using conventional polypropylene sutures (Group C). Postoperative evaluations were performed at 1, 3 and 6 months after operations.
RESULTS: The proximal anastomosis time was 14.9 ± 3.6 min in group D and 21.3 ± 7.0 min in group C (p < 0.05). The distal suture time was 14.2 ± 2.9 min in group D and 22.3 ± 4.8 min in group C (p < 0.05). The operation time was 106.6 ± 12.1 min in group D and 136.6 ± 11.8 min in group C (p < 0.05). Graft flow was 21.8 ± 4.8 mL/min in group D and 11.2 ± 6.9 mL/min in group C (p < 0.05). There are 4 occlusion cases in group D and 3 in group C. Graft flow at 1 month was 17.7 ± 1.2 mL/min in group D and 5.3 ± 5.3 mL/min in group C (p < 0.05), but there were no significant difference at 3 and 6 months. Pathological findings revealed there was no specific inflammatory reaction to the device.
CONCLUSIONS: The device that we developed was shown to be more effective than conventional suture under endoscopic environment. The device evoked no additional inflammatory change at the anastomoses.


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