Ventricular-Coronary Conduit Device Developed in Germany

BERLIN (Reuters Health) -The days of the traditional coronary artery bypass graft could be numbered, with the introduction of a device developed by scientists in Germany that connects an occluded coronary artery directly to the left ventricle.

The Teflon covered device, termed a V-stent, could eventually be implanted using minimally invasive surgery techniques.

Professor Bruno Reichart of the Munich University Hospital explained that the five patients who had received the V-stents since this spring, were doing well and that the procedure seemed promising when compared to conventional bypass operations.

“The connection is very short, the stent being between 17 and 28 millimetres compared to the average 10-centimetre conventional bypass length,” he told Reuters Health.

The idea is that the far shorter bypass reduces the risk of restenosis. It should thus be suitable for older patients whose weaker veins might make a conventional bypass risky.

“It is quite easy to do, just open the artery with a puncture, put in a wire, exchange it with a balloon and the stent goes in. This is all done during surgery at the moment. What we did with our patients was to work on four stenosis-affected vessels–three were given conventional bypasses while the other got a V-stent.”

Professor Reichart explained that the technique had been practiced on pigs for the last five years with good results.

“The blood-flow physiology is different, as the blood reaches the artery during the contraction movement of the heart rather than the relaxed period,” he said. “We saw that it is all the same for the heart — it is only dependent on the blood reaching it rather than what part of the beat cycle it comes on.”

He said that the team had conducted follow-up examinations on the five patients at between 4 weeks and 3 months after the operations, a process which should continue for at least a year. “So far we have seen that the connection to the stent remained open and the function of the bypass is OK in the short term.

This is just the first generation of V-stents, Dr. Reichart pointed out. “If it turns out to be helpful and if the hopes we have are substantiated, then certainly it might make ÄbypassÅ operations much faster and easier. It takes a few minutes to do, at the moment about 15 minutes, which is about the same as a conventional bypass operation, but we are being extra careful at the moment and it could become much faster.”

In a year or two, he believes, “It could be done with minimal invasive surgery techniques and even using robotics.”