The new U-Clip device: Facilitated vascular interrupted anastomosis without knot-tying

• Published in: The Thoracic and Cardiovascular Surgeon
• Main Authors: Berdat, PA, Kipfer, B, Pavlovic, M, Pfammatter, JP, Carrel, T
• Format: Conference Proceeding
• Language: German
• Published: 30.01.2004
• ISSN: 0171-6425; 1439-1902
• DOI: 10.1055/s-2004-816829

Objective: Assessment of clinical application and early results of the U-clip device, facilitating creation of interrupted vascular anastomoses in cardiovascular surgery. Methods: U-clips were used in 51 patients (age 51±29y, EF 55±14%, NYHA class 3±0.9, 37 male) for peripheral vascular procedures (5; 9.8%), CABG (34; 66.7%), and congenital cardiac procedures (12; 23.5%) in a total of 59% (115/196) of all vascular anastomoses made. Assessment of anastomotic quality by Transit-time Doppler (TTD), invasive pressure gradient measurements, and echocardiography. Results: Mean operation time was 193±56min, CPB 76±27min., AXC 49±27min. In all cases the use of the U-clips was easy and no technical difficulties were encountered. Anastomotic flow was excellent (LITA-LAD 40.4±10.8; RA-RCX 53.5±19; SVC-RCA or RCX 63.4±339.7ml/min) and pressure gradients minimal in all cases. Compared to conventional polypropylene running sutures, anastomotic compliance of LITA-LAD, measured with the Pulsatility Index provided by TTD, was significantly better with the U-clip (1.9±0.26 vs. 2.7±0.65; p=.0128). No device-related complications occurred. During a follow-up of 12.9±5.6 months 1 newborn died after 62d (1.96%). Conclusions: Construction of a functionally interrupted anastomosis is greatly facilitated with the use of the U-clips. Its greater anastomotic diameter, pulsatility of the anastomosis and unrestricted growth potential in comparison to running suture techniques may help prevent anastomotic stenosis. With elimination of knot-tying the U-clips may be an ideal suture device in minimally invasive, thoracoscopic and robot-assisted procedures.