Background: The Heartflo™ device was developed to facilitate consistency in distal coronary anastomosis quality. The device automates the suturing process during the anastomosis procedure via simultaneous delivery of ten standard 7 - 0 polypropylene sutures through the graft and the coronary vessel wall. Methods: In 30 elective coronary artery bypass patients, one distal anastomosis was intentionally performed with the anastomosis device. Device success was stated if a patent anastomosis with a minimal flow of 50 ml/min resulted, additional stitches were counted if bleeding occurred. Results: 4 cases of device failure occurred in the first 5 patients. The subsequent patients were operated without any mechanical problems. In 16 patients (53 %), a patent anastomosis with a mean flow of 75 ± 6 ml/min using 1.7 ± 0.3 additional stitches was achieved. Anastomoses were completed in 19.0 ± 0.7 min; postoperative course was uneventful in all patients. Conclusions: We have shown that coronary anastomoses are feasible using the Heartflo™ device, representing a promising step on the way to automated coronary anastomoses. Its application is still limited by the size and tissue quality of the target vessel and difficult suture management during the anastomosis procedure.
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