Wednesday, October 29, 2003 - 8:25 AM

Sutureless Anastomosis of a Vein Graft Using Magnets

Christoph D. Heitmann, MD, Fahar N. Khan, MD, Adam A. Sharkawy, PhD, Bruce Klitzman, MD, PhD, Kevin C. Olbrich, PhD, and Detelev Erdmann, MD.

ABSTRACT Background: Performing vascular anastomoses requires complete circumferential access, is time-consuming and technically challenging. The purpose of our study was to assess the efficacy of sutureless vascular anastomoses utilizing a magnetic device. Methods and Results: Oval magnets with a lumen were placed in six male foxhounds. The femoral artery was ligated and a 8 cm length of femoral vein was harvested and reversed. After a 4 mm venotomy or arteriotomy, one magnet was inserted into each vessel lumen and a second magnet was placed outside the vessel but aligned directly over the intraluminal magnet, forming a magnetic port in each vessel. The graft and target vessels were then allowed to self-align and seal, creating a side-to-side anastomosis. Patency was confirmed with Duplex Doppler ultrasound scans after 6 and 13 weeks later and during explantation after 14 weeks. At that time, the contralateral femoral vein was harvested and an acute graft was created as a control. Macroscopically there was no sign of stenoses or aneurysms. After explant, saline was perfused through all grafts and the hydrodynamic resistance was quantified. There was no significant difference in resistance between the acute and 14-week grafts indicating stenosis. Microscopic examination of 14-week anastomoses showed that all blood-contacting surfaces were well-endothelialized. Conclusions: The magnetic vascular coupler allowed sutureless anastomoses between blood arteries and veins. This device might prove useful for anastomosis of large and small vessels, as well as for anastomosis or approximation of non-vascular structures such as peripheral nerves, fallopian tubes or ureters.

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