Abstract 2881: New Distal Anastomotic Device for LIMA-LAD Bypass Grafts Provides 100% Early Patency by 64 Slice CT Angiography at 30 Days
Introduction: Traditional coronary artery bypass grafting is performed using a hand sewn technique. The C Port xA and Flex A anastomotic stapling devices (Cardica, Redwood City, CA) were cleared by the FDA for use in distal coronary anastomoses in Nov 2006 and April 2007 respectively. They provide the ability to create a compliant, consistently reproducible, and automated anastomosis with the push of a button. Multidetector computed tomography has been shown to be effective in evaluating coronary artery bypass graft patency.
Methods: 24 patients underwent off pump coronary bypass grafting using the C Port xA or Flex A anastomotic device for the LIMA-LAD anastomosis. We evaluated early (30 day) graft patency in the first 10 patients using 64 slice computed tomography. An 11th patient underwent formal coronary angiography 1 week after surgery as part of a hybrid revascularization.
Results: There were no perioperative strokes, myocardial infarctions or deaths. All 24 patients were discharged home. All 10 LIMA LAD grafts evaluated at 30 days were patent using 64-slice multidetector computed tomography. The graft evaluated at one week with formal angiography was also widely patent.
Conclusion: The C Port xA and FlexA distal anastomotic devices provided a safe and effective means to create a LIMA -LAD anastomoses in coronary bypass surgery with excellent short term patency in this very early experience. Long term follow up is warranted. These findings will have important implications for future sternal sparing coronary bypass surgery.