# Comparison of Two Coronary Anastomosis Techniques in Terms of Flow Rate in Porcine Hearts

## TL;DR

This study compares two techniques for coronary anastomosis in pig hearts and finds that one method improves flow rates and anastomosis area.

## Contribution

The study introduces a novel anastomotic technique involving epicardial fat to enhance graft flow and anastomosis area.

## Key findings

- The CWE technique had a significantly shorter flow time (77.5 seconds) compared to the OCW technique (87.2 seconds).
- The CWE technique resulted in a larger anastomotic area (3.947 mm²) compared to the OCW technique (1.430 mm²).
- Involving epicardial fat in the anastomosis may improve graft flow and hemodynamic performance.

## Abstract

The quality of coronary anastomoses is one of the important parameters that
may affect graft patency in coronary artery bypass grafting patients.
Therefore, we compared two different anastomotic techniques to improve graft
flow and patency rates.

This study was conducted by performing two different fashions of anastomosis
with a human saphenous vein graft on 24 various coronary segments of five
postmortem porcine hearts. Each arteriotomy was used for both anastomotic
techniques. In the first method, epicardial fat tissue around the coronary
artery was involved to the saphenous vein anastomosis line (coronary wall
and epicardial fat tissue [CWE] technique). In the second method, the
saphenous vein graft was sutured to the coronary wall only, without
involving epicardial fat tissue (only coronary wall [OCW] technique).The
time it tookfor 30 cc of 0.9% isotonic saline solution to pass through the
anastomosis in a free-flow fashion by gravity was measured following each
technique. Additionally, the anastomotic areas in mm2 were
measured and compared between the two techniques.

The mean flow time for the CWE technique was 77.5 ± 21.4 seconds,
whereas for the OCW technique, it was 87.2 ± 19.5 seconds
(P<0.001). The flow rates were 23.2 ml/min and 20.6
ml/min, respectively. The anastomotic area was 3.947 mm2 for the
CWE technique and 1.430 mm2 for the OCW technique.

When the sutures penetrate both the epicardial fat tissue and the coronary
artery wall simultaneously, a larger anastomosis area can be created.
Consequently, potentially better graft flow and hemodynamic performance
could be achieved.