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Titolo:
INTIMA-ADVENTITIA APPOSITION IN END-TO-SIDE ARTERIAL ANASTOMOSIS - ANEXPERIMENTAL-STUDY IN THE PIG
Autore:
HEIJMEN RH; GRUNDEMAN PF; BORST C;
Indirizzi:
UNIV UTRECHT HOSP,DEPT CARDIOL,RM G02523,POB 85500 NL-3508 GA UTRECHTNETHERLANDS UNIV UTRECHT HOSP,DEPT CARDIOL NL-3508 GA UTRECHT NETHERLANDS
Titolo Testata:
The Annals of thoracic surgery
fascicolo: 3, volume: 65, anno: 1998,
pagine: 705 - 711
SICI:
0003-4975(1998)65:3<705:IAIEAA>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
CYCLIC FLOW VARIATIONS; CARDIOPULMONARY BYPASS; PLATELET-AGGREGATION; ENDOTHELIAL INJURY; EXCIMER LASER; CORONARY; EXPERIENCE; STENOSIS; VESSELS; SURGERY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
22
Recensione:
Indirizzi per estratti:
Citazione:
R.H. Heijmen et al., "INTIMA-ADVENTITIA APPOSITION IN END-TO-SIDE ARTERIAL ANASTOMOSIS - ANEXPERIMENTAL-STUDY IN THE PIG", The Annals of thoracic surgery, 65(3), 1998, pp. 705-711

Abstract

Background. To prevent ischemic complications during coronary bypass grafting on the beating heart, a nonocclusive distal anastomosis technique is needed. One recently developed nonocclusive technique requiresapposition of the intima of the graft to the adventitia of the recipient artery, in contrast to current surgical;practice, which dictates apposition of both intimas. Methods. To compare the sole effect of intima-adventitia apposition (n = 18) versus traditional intima-intima apposition (n = 18), we investigated radiolabeled platelet deposition andhistomorphologic aspects of vascular wall healing quantitatively in aporcine carotid artery bypass graft model. Both groups were evaluatedat 2 hours, 2 days, or 4 weeks. Results. Within the first 2 hours, 3 of 6 pigs with intima-adventitia apposition exhibited cyclic flow reductions as a result of massive mural thrombosis. After intima-adventitia apposition, the number of deposited platelets was significantly higher compared with intima-intima apposition, 147.1 +/- 73.0 x 10(6) and 4.6 +/- 1.0 x 10(6) platelets/cm(2) (mean +/- standard error of the mean), respectively (p = 0.03). At 2 days, the suture line was covered with Small mural thrombi, whereas no thrombi were found after intima-intima apposition. At 4 weeks, intimal hyperplasia at heel and toe was not significantly different from that with intima-intima apposition. Conclusions. Despite thrombotic phenomena in the early phase, intima-adventitia apposition yielded a patent anastomosis with a small intimal hyperplasia response. (C) 1998 by The Society of Thoracic Surgeons.

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Documento generato il 29/03/20 alle ore 14:51:04