Abstract
The surgical treatment for aortic diseases remains a challenge for any cardiac surgeon. The use of sutureless ring connector in aortic anastomosis can simplify the procedure and shorten anastomosis time. Therefore, we developed a novel device for sutureless aortic anastomosis. A series of experiments were carried out for tensile and leakproof-capacity assessments to verify the feasibility of the ring connector by using fresh swine aorta samples. In in vivo test, the ring connector was implanted in 6 swine with follow-up of 6 months. Radiographic and pathological studies of the aorta were performed. In the tensile tests, the strength was 32.7±5.9 Newton (N) in the sutureless anastomosis group, compared with 73.3±12.5 N in the control group by traditional manual suture. In the leakproof-capacity assessment, no sign of either leakage or bursting was evident at 280 mmHg of internal pressure in the aorta samples. In in vivo tests, it took 9.47±0.3 minutes for the sutureless anastomosis, compared with 15.58±1.39 minutes for hand-sewn suturing. Insertion was easy and rapid. Radiographic and pathological studies were performed at first month, third month and sixth month after surgery, each time obtained from the two swine, showed patency of the anastomosis and no signs of stenosis, blood leakage, migration or pseudoaneurysm formation, except one paralyzed swine developed of thrombo-occlusion at the site of the sutureless anastomosis. The result indicates that this novel ring connector offers considerable promise for sutureless aortic anastomosis.
Highlights
Since the beginning of cardiovascular surgery, anastomoses have been done with hand-sewn sutures based on the principles of the suture technique described by Alexis Carrel[1]
The surgical treatment for aortic diseases remains a challenge for cardiothoracic surgeons
Paraplegia and brain damage are devastating complications after aortic reconstruction while the prolonged pumping time. These in vitro testing results demonstrated that the new sutureless device constructed an anastomosis with reliable mechanical strength and leakproofcapacity
Summary
Since the beginning of cardiovascular surgery, anastomoses have been done with hand-sewn sutures based on the principles of the suture technique described by Alexis Carrel[1]. Improvements in surgical techniques that reduce clamp time and make the procedure technically easier would be of CLC number: R654.2, Document code: A The authors reported no conflict of interests.
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