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Eur J Cardiothorac Surg 2001;19:477-481
© 2001 Elsevier Science NL

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

^a Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon, 46, 1011 Lausanne, Switzerland
^b Department of Vascular Medecine, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon, 46, 1011 Lausanne, Switzerland

Received 2 October 2000; received in revised form 21 January 2001; accepted 23 January 2001.

Corresponding author. Tel.:+41-21-314-2280; fax: +41-21-314-2278
e-mail: tozzig{at}hotmail.com

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=xmM/4 where m and M are the minor and major axes of the elliptical anastomosis. Cross-sectional anastomotic compliance (CSAC) was calculated as CSAC=CSAA/P where P is the mean pulse pressure and CSAA 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 CSAA was 0.64 mm²). CSAC for running suture was 4.5x10^-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 CSAA was 4.6±0.1 mm²). CSAC for interrupted suture was 11x10^-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^TM anastomosis device is a reliable instrument that facilitates performance of interrupted suture anastomoses.

Key Words: Vascular anastomosis • Arterial compliance • Piezoelectric crystals

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