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Tension to arterial anastomoses: 7.0 vs 8.0 suture in CT and REM imaging
Rene Bombien1, Katharina Plonien2, Maximilian Friedrich2, Paul Philipp Heinisch2, Ralf Brecht1, Bassil Akra1.
1Clinic of Surgery, LMU, Munich, Munich, Germany, 2Clinic of Cardiac Surgery, LMU, Munich, Munich, Germany.
OBJECTIVE:The quality of bypass anastomoses depends on graft consistence, suture material, and surgeon’s fate. Short bypasses can lead to graft tension that impairs their function. In this study, the effect of bypass tension to porcine mammarian artery anastomoses using different suture sizes was analyzed.
METHODS:Ten anastomoses have been sutured using porcine mammarian arteries (5 with 7.0 monofil suture, 5 with 8.0 monofil suture). Tension (0.5N, 1N) was applied to the anastomoses in each group. Two remained as control. Bypass perfusion in CT imaging, gross anatomy, and scanning electron microscopy (SEM) analyses after tension have been performed.
RESULTS:After applying tension to the graft, no anastomose ruptured. In the 7.0 group at 1 N, the anastomose showed significant fissures in gross anatomy and SEM in contrast to the 8.0 sutured anastomoses. The constrast angiogram as well as the contrast CT showed at 1 N significant impairment of bypass flow of more than 50%.
CONCLUSIONS:This in vitro study demonstrates that in case of bypass tension the bypass flow is significantly reduced. In case of tension stress onto the anastomose, the 8.0 sutured anastomoses seems to be more stable than a 7.0 sutured anastomose.
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