Fulltext

Animal model to compare the effects of suture technique on cross-sectional compliance on end-to-side anastomoses

Tozzi, P. ; Hayoz, D. ; Ruchat, P. ; Corno, A. ; Oedman, C. ; Botta, U. ; von Segesser, L.K.

In: European Journal of Cardio-Thoracic Surgery, 2001, vol. 19, no. 4, p. 477-481

Ajouter à la liste personnelle
    Titre
    • Animal model to compare the effects of suture technique on cross-sectional compliance on end-to-side anastomoses
    Auteur
    • Tozzi, P.. Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon, 46, 1011 Lausanne, Switzerland
    • Hayoz, D.. Department of Vascular Medecine, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon, 46, 1011 Lausanne, Switzerland
    • Ruchat, P.. Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon, 46, 1011 Lausanne, Switzerland
    • Corno, A.. Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon, 46, 1011 Lausanne, Switzerland
    • Oedman, C.. Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon, 46, 1011 Lausanne, Switzerland
    • Botta, U.. Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon, 46, 1011 Lausanne, Switzerland
    • von Segesser, L.K.. Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon, 46, 1011 Lausanne, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Journal of Cardio-Thoracic Surgery, 2001, vol. 19, no. 4, p. 477-481. Elsevier Science B.V.
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:293229
    Summary
    Objective: An animal model has been developed to compare the effects of suture technique on the luminal dimensions and compliance of end-to-side vascular anastomoses. Methods: Carotid and internal mammalian arteries (IMAs) were exposed in three pigs (90 kg). IMAs were sectioned distally to perform end-to-side anastomoses on carotid arteries. One anastomosis was performed with 7/0 polypropylene running suture. The other was performed with the automated suture delivery device (Perclose/Abbott Labs Inc.) that makes a 7/0 polypropylene interrupted suture. Four piezoelectric crystals were sutured on toe, heel and both lateral sides of each anastomosis to measure anastomotic axes. Anastomotic cross-sectional area (CSAA) was calculated with: CSAA = π × mM/4 where m and M are the minor and major axes of the elliptical anastomosis. Cross-sectional anastomotic compliance (CSAC) was calculated as CSAC = δCSAA/δP where δP is the mean pulse pressure and δCSAA is the mean CSAA during cardiac cycle. Results: We collected a total of 1 200 000 pressure-length data per animal. For running suture we had a mean systolic CSAA of 26.94±0.4 mm2 and a mean CSAA in diastole of 26.30±0.5 mm2 (mean δCSAA was 0.64 mm2). CSAC for running suture was 4.5×10−6m2/kPa. For interrupted suture we had a mean CSAA in systole of 21.98±0.2 mm2 and a mean CSAA in diastole of 17.38±0.3 mm2 (mean δCSAA was 4.6±0.1 mm2). CSAC for interrupted suture was 11×10−6 m2/kPa. Conclusions: This model, even with some limitations, can be a reliable source of information improving the outcome of vascular anastomoses. The study demonstrates that suture technique has a substantial effect on cross-sectional anastomotic compliance of end-to-side anastomoses. Interrupted suture may maximise the anastomotic lumen and provides a considerably higher CSAC than continuous suture, that reduces flow turbulence, shear stress and intimal hyperplasia. The Heartflo™ anastomosis device is a reliable instrument that facilitates performance of interrupted suture anastomoses