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Internal Mammary Coronary Artery Anastomosis by Co 2 Laser: An Acute Experimental Study
Author(s) -
BASU SAMIR,
MARINI CORRADO P.,
COONS MATTHEW S.,
WOLOSZYN THOMAS T.,
FOLLIGUET THIERRY A.,
BAUMANN F. GREGORY,
JACOBOWITZ ISRAEL J.
Publication year - 1991
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.1991.tb00311.x
Subject(s) - medicine , mammary artery , anastomosis , cardiology , artery , surgery
A bstract This study was designed to determine the feasibility of anastomosing the internal mammary artery (IMA) and coronary artery with a carbon dioxide laser in a canine model. Twenty‐two mongrel dogs were randomly assigned to two groups: group I (n = 11) underwent laser‐assisted vascular anastomosis (LAVA) of the left IMA to the left anterior descending (LAD) coronary artery, whereas in group II (n = 11) the anastomosis was done with the conventional technique (handsewn). Laser methodology was used to micro‐weld vessels utilizing a power of 200 mW with a spot size of 500 μ, producing an effective power density of 102 W/cm 2 and energy fluence of 9, 172 joules/cm 2 in a continuous mode at a distance of 2 cm. The short‐term patency rate, measured at 2 hours after completion of the anastomosis, was 100% in both groups. The time required to perform the LAVA in group I was significantly shorter than group II (6.27 ± 0.47 vs 11.6 ± 0.67 min, p < 0.05). The mean anastomotic bursting pressure in group I was significantly lower compared to group II (348 ± 8 vs 402 ± 9 mmHg, p < 0.05). Histologic evaluation of all vessels showed moderate thermal injury of the adventitia and media in the laser group. Scanning electron microscopy exhibited a smooth anastomotic area in group I, whereas endothelial and perianastomotic changes with multiple needle craters occurred in group II (conventional anastomosis). Based on the results of this study, we conclude that a low powered CO 2 laser can be used to safely perform an IMA to LAD artery anastomosis, thus providing an alternative to conventional techniques because of its rapidity and minimization of anastomotic changes.