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Arteriotomy

The Experts below are selected from a list of 282 Experts worldwide ranked by ideXlab platform

Paul F Grundeman – 1st expert on this subject based on the ideXlab platform

  • Arteriotomy closure by glued patch in the porcine carotid artery
    The Annals of Thoracic Surgery, 2000
    Co-Authors: Jacqueline Bastiaanse, Yvonne J M Van Der Helm, Cornelius Borst, Paul F Grundeman

    Abstract:

    Abstract Background . A thoracoscopic approach to coronary bypass grafting warrants renewed search for facilitated vascular anastomosis methods. We reassessed tissue adhesion, sealing properties, and histotoxicity of iso-butyl-cyanoacrylate, in a simplified anastomosis model. Methods . In 12 Dutch landrace pigs, five arteriotomies were made in each carotid artery. The arteriotomies were closed by conventional microvascular suturing or by pericardial patch (Peri-Strips) and iso-butyl-cyanoacrylate. The animals were sacrificed at 2 hours (n = 2), 2 days (n = 5), and 4 weeks (n = 5). The arteries were examined by flow measurement, angiography, and histologic analysis. Results . The time required to close arteriotomies by conventional suturing was 257 ± 43 seconds (mean ± SD) and by glued patch 51 ± 27 seconds ( p Conclusions . Arteriotomy closure by glued patch was simple, fast, reliable, and without signs of histotoxicity. Adhesives deserve to be reconsidered as an alternative to suturing in closed chest beating-heart coronary surgery.

  • temporary luminal Arteriotomy seal iii postmortem arteriosclerotic human coronary artery
    The Annals of Thoracic Surgery, 1999
    Co-Authors: Robin H Heijmen, Paul F Grundeman, Cornelius Borst, Chantal M Moues, Yvonne J M Van Der Helm, Gerard Pasterkamp

    Abstract:

    BACKGROUND: Recently, we described a temporary luminal Arteriotomy seal that provided a bloodless Arteriotomy without obstructing recipient artery blood flow during bypass grafting in nonarteriosclerotic porcine arteries. This postmortem study assessed the sealing properties in irregular arteriosclerotic human coronary arteries. METHODS: Three hearts were obtained from donated corpses within 24 hours of death. The coronary arteries were pressure-perfused at 60 mm Hg with citrated porcine blood. At 15 anastomosis sites in four different coronary arteries, an end-to-side anastomosis was created using a 200-microm-thick polyurethane seal. Adequacy of sealing was determined at perfusion pressures of 60, 40, and 20 mm Hg. RESULTS: After insertion, the Arteriotomy was sealed instantaneously in 10 of 15 anastomoses. After repositioning, complete sealing with a bloodless operative field was obtained in all cases. Low intracoronary transmural pressure did not impede sealing. In 8 of 15 anastomoses, minor leakage without obscuring the Arteriotomy edges was observed during anastomotic suturing. Histologic examination revealed no intimal tear or dissection caused by the anastomotic procedure. CONCLUSIONS: In postmortem-obtained arteriosclerotic human coronary arteries, the temporary luminal Arteriotomy seal provided optimal visualization of the coronary anastomosis site in combination with persistent distal perfusion.

  • temporary luminal Arteriotomy seal ii coronary artery bypass grafting on the beating heart
    The Annals of Thoracic Surgery, 1998
    Co-Authors: Robin H Heijmen, Cornelius Borst, Rob Van Dalen, Cees W J Verlaan, Chantal M Moues, Yvonne J M Van Der Helm, Paul F Grundeman

    Abstract:

    Abstract Background . This study assessed the feasibility of applying a temporary luminal Arteriotomy seal during end-to-side coronary artery bypass grafting on the beating heart. Methods . In 18 consecutive pigs, the left internal mammary artery was grafted to the left anterior descending coronary artery, and the Arteriotomy was temporarily sealed luminally by a 200-μm-thick polyurethane seal. Endothelial denudation, medial necrosis, and intimal hyperplasia were measured quantitatively and compared with conventionally sutured anastomoses (n = 4 pigs). Results . Insertion and retrieval of the seal required 28 ± 12 and 11 ± 6 seconds, respectively. Including the Arteriotomy, coronary artery occlusion was limited to about 80 seconds. The seal provided a bloodless Arteriotomy in all anastomoses with unimpeded coronary artery blood flow. Endothelial denudation was limited to two thirds of the circumference of the coronary artery. No medial necrosis was found. Intimal hyperplasia at the suture line was small, although more pronounced when compared with conventionally sutured anastomoses. Conclusions . In off-pump, beating-heart coronary artery bypass grafting, the temporary luminal Arteriotomy seal provided a bloodless Arteriotomy with negligible obstruction to coronary artery blood flow, and with a minimum of arterial wall damage. It is conceivable that this seal may expand the indications for coronary surgical procedures without cardiopulmonary bypass.

Robin H Heijmen – 2nd expert on this subject based on the ideXlab platform

  • temporary luminal Arteriotomy seal iii postmortem arteriosclerotic human coronary artery
    The Annals of Thoracic Surgery, 1999
    Co-Authors: Robin H Heijmen, Paul F Grundeman, Cornelius Borst, Chantal M Moues, Yvonne J M Van Der Helm, Gerard Pasterkamp

    Abstract:

    BACKGROUND: Recently, we described a temporary luminal Arteriotomy seal that provided a bloodless Arteriotomy without obstructing recipient artery blood flow during bypass grafting in nonarteriosclerotic porcine arteries. This postmortem study assessed the sealing properties in irregular arteriosclerotic human coronary arteries. METHODS: Three hearts were obtained from donated corpses within 24 hours of death. The coronary arteries were pressure-perfused at 60 mm Hg with citrated porcine blood. At 15 anastomosis sites in four different coronary arteries, an end-to-side anastomosis was created using a 200-microm-thick polyurethane seal. Adequacy of sealing was determined at perfusion pressures of 60, 40, and 20 mm Hg. RESULTS: After insertion, the Arteriotomy was sealed instantaneously in 10 of 15 anastomoses. After repositioning, complete sealing with a bloodless operative field was obtained in all cases. Low intracoronary transmural pressure did not impede sealing. In 8 of 15 anastomoses, minor leakage without obscuring the Arteriotomy edges was observed during anastomotic suturing. Histologic examination revealed no intimal tear or dissection caused by the anastomotic procedure. CONCLUSIONS: In postmortem-obtained arteriosclerotic human coronary arteries, the temporary luminal Arteriotomy seal provided optimal visualization of the coronary anastomosis site in combination with persistent distal perfusion.

  • temporary luminal Arteriotomy seal ii coronary artery bypass grafting on the beating heart
    The Annals of Thoracic Surgery, 1998
    Co-Authors: Robin H Heijmen, Cornelius Borst, Rob Van Dalen, Cees W J Verlaan, Chantal M Moues, Yvonne J M Van Der Helm, Paul F Grundeman

    Abstract:

    Abstract Background . This study assessed the feasibility of applying a temporary luminal Arteriotomy seal during end-to-side coronary artery bypass grafting on the beating heart. Methods . In 18 consecutive pigs, the left internal mammary artery was grafted to the left anterior descending coronary artery, and the Arteriotomy was temporarily sealed luminally by a 200-μm-thick polyurethane seal. Endothelial denudation, medial necrosis, and intimal hyperplasia were measured quantitatively and compared with conventionally sutured anastomoses (n = 4 pigs). Results . Insertion and retrieval of the seal required 28 ± 12 and 11 ± 6 seconds, respectively. Including the Arteriotomy, coronary artery occlusion was limited to about 80 seconds. The seal provided a bloodless Arteriotomy in all anastomoses with unimpeded coronary artery blood flow. Endothelial denudation was limited to two thirds of the circumference of the coronary artery. No medial necrosis was found. Intimal hyperplasia at the suture line was small, although more pronounced when compared with conventionally sutured anastomoses. Conclusions . In off-pump, beating-heart coronary artery bypass grafting, the temporary luminal Arteriotomy seal provided a bloodless Arteriotomy with negligible obstruction to coronary artery blood flow, and with a minimum of arterial wall damage. It is conceivable that this seal may expand the indications for coronary surgical procedures without cardiopulmonary bypass.

  • temporary luminal Arteriotomy seal for bypass grafting
    The Annals of Thoracic Surgery, 1998
    Co-Authors: Robin H Heijmen, Paul F Grundeman, Cornelius Borst, Rob Van Dalen, Cees W J Verlaan

    Abstract:

    Abstract Background . To enable off-pump coronary operations in a bloodless surgical field without ischemic complications, we developed and assessed a temporary luminal Arteriotomy seal in a porcine carotid artery bypass graft model. Methods . In 16 consecutive pigs (25 kg, 32 anastomoses) the Arteriotomy was sealed luminally by a polyurethane elliptic convex seal. Endothelial denudation, medial necrosis, and intimal hyperplasia were measured quantitatively and compared with those seen in conventionally sutured anastomoses. Results . The median occlusive time upon insertion or retrieval was 90 and 82 seconds, including the Arteriotomy and securing the anastomosis, respectively. Once properly positioned, the seal provided a bloodless Arteriotomy in all anastomoses. Microsurgical suturing was performed without leakage of the seal and with unimpeded flow. In the recipient artery, endothelial denudation was limited to one third of its circumference. No medial necrosis was found. Intimal hyperplasia at heel and toe was not significantly different from that seen in conventionally sutured anastomoses. Conclusions . During end-to-side bypass grafting, the temporary luminal Arteriotomy seal provided a bloodless surgical field without interfering with recipient artery blood flow and with minimal damage to the arterial wall.

Cornelius Borst – 3rd expert on this subject based on the ideXlab platform

  • Arteriotomy closure by glued patch in the porcine carotid artery
    The Annals of Thoracic Surgery, 2000
    Co-Authors: Jacqueline Bastiaanse, Yvonne J M Van Der Helm, Cornelius Borst, Paul F Grundeman

    Abstract:

    Abstract Background . A thoracoscopic approach to coronary bypass grafting warrants renewed search for facilitated vascular anastomosis methods. We reassessed tissue adhesion, sealing properties, and histotoxicity of iso-butyl-cyanoacrylate, in a simplified anastomosis model. Methods . In 12 Dutch landrace pigs, five arteriotomies were made in each carotid artery. The arteriotomies were closed by conventional microvascular suturing or by pericardial patch (Peri-Strips) and iso-butyl-cyanoacrylate. The animals were sacrificed at 2 hours (n = 2), 2 days (n = 5), and 4 weeks (n = 5). The arteries were examined by flow measurement, angiography, and histologic analysis. Results . The time required to close arteriotomies by conventional suturing was 257 ± 43 seconds (mean ± SD) and by glued patch 51 ± 27 seconds ( p Conclusions . Arteriotomy closure by glued patch was simple, fast, reliable, and without signs of histotoxicity. Adhesives deserve to be reconsidered as an alternative to suturing in closed chest beating-heart coronary surgery.

  • temporary luminal Arteriotomy seal iii postmortem arteriosclerotic human coronary artery
    The Annals of Thoracic Surgery, 1999
    Co-Authors: Robin H Heijmen, Paul F Grundeman, Cornelius Borst, Chantal M Moues, Yvonne J M Van Der Helm, Gerard Pasterkamp

    Abstract:

    BACKGROUND: Recently, we described a temporary luminal Arteriotomy seal that provided a bloodless Arteriotomy without obstructing recipient artery blood flow during bypass grafting in nonarteriosclerotic porcine arteries. This postmortem study assessed the sealing properties in irregular arteriosclerotic human coronary arteries. METHODS: Three hearts were obtained from donated corpses within 24 hours of death. The coronary arteries were pressure-perfused at 60 mm Hg with citrated porcine blood. At 15 anastomosis sites in four different coronary arteries, an end-to-side anastomosis was created using a 200-microm-thick polyurethane seal. Adequacy of sealing was determined at perfusion pressures of 60, 40, and 20 mm Hg. RESULTS: After insertion, the Arteriotomy was sealed instantaneously in 10 of 15 anastomoses. After repositioning, complete sealing with a bloodless operative field was obtained in all cases. Low intracoronary transmural pressure did not impede sealing. In 8 of 15 anastomoses, minor leakage without obscuring the Arteriotomy edges was observed during anastomotic suturing. Histologic examination revealed no intimal tear or dissection caused by the anastomotic procedure. CONCLUSIONS: In postmortem-obtained arteriosclerotic human coronary arteries, the temporary luminal Arteriotomy seal provided optimal visualization of the coronary anastomosis site in combination with persistent distal perfusion.

  • temporary luminal Arteriotomy seal ii coronary artery bypass grafting on the beating heart
    The Annals of Thoracic Surgery, 1998
    Co-Authors: Robin H Heijmen, Cornelius Borst, Rob Van Dalen, Cees W J Verlaan, Chantal M Moues, Yvonne J M Van Der Helm, Paul F Grundeman

    Abstract:

    Abstract Background . This study assessed the feasibility of applying a temporary luminal Arteriotomy seal during end-to-side coronary artery bypass grafting on the beating heart. Methods . In 18 consecutive pigs, the left internal mammary artery was grafted to the left anterior descending coronary artery, and the Arteriotomy was temporarily sealed luminally by a 200-μm-thick polyurethane seal. Endothelial denudation, medial necrosis, and intimal hyperplasia were measured quantitatively and compared with conventionally sutured anastomoses (n = 4 pigs). Results . Insertion and retrieval of the seal required 28 ± 12 and 11 ± 6 seconds, respectively. Including the Arteriotomy, coronary artery occlusion was limited to about 80 seconds. The seal provided a bloodless Arteriotomy in all anastomoses with unimpeded coronary artery blood flow. Endothelial denudation was limited to two thirds of the circumference of the coronary artery. No medial necrosis was found. Intimal hyperplasia at the suture line was small, although more pronounced when compared with conventionally sutured anastomoses. Conclusions . In off-pump, beating-heart coronary artery bypass grafting, the temporary luminal Arteriotomy seal provided a bloodless Arteriotomy with negligible obstruction to coronary artery blood flow, and with a minimum of arterial wall damage. It is conceivable that this seal may expand the indications for coronary surgical procedures without cardiopulmonary bypass.