End-to-side anastomosis using a new sutureless vascular prosthesis

Performing a conventional vascular anastomosis during minimally invasive surgery remains a technically difficult and time-consuming task. The purpose of our study was to assess the efficacy of a new sutureless vascular prosthesis. Through a left thoracotomy, a short segment of the descending aorta was bypassed in eight sheep. Our Dacron prosthesis had a cuff at one extremity. The cuff was introduced into the artery through an arteriotomy and attached to the arterial wall with clips. Surgery was performed on the sheep again 12-15 weeks later, and the prosthesis was retrieved for macroscopic and microscopic examination. At surgery, insertion of the prosthesis was easy, fast, and safe. A 3-4 mm space between each clip was required for proper attachment. At the second surgery, all prostheses were completely patent and there were no anastomotic stenoses or aneurysms. This new sutureless vascular prosthesis was easy and safe in its placement and might prove useful for video assisted vascular aortic surgery.