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Coronary Artery Anastomosis🪡🤏 👉Precise needle angle, symmetric bites, and gentle tissue handling.

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WithAScalpel - Fumiya Yoneyama, MD, PhD

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34,457 просмотров • 2 месяцев назад •via X (Twitter)

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End-to-Side Vascular Anastomosis: End-to-side anastomosis hinges on alignment and gentle handling. Size the arteriotomy, define heel and toe, then secure the far wall first to lock orientation. Use symmetric bites with uniform spacing, maintain tension, avoid intimal catching, and seat knots without strangulation.
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End-to-Side Vascular Anastomosis: End-to-side anastomosis hinges on alignment and gentle handling. Size the arteriotomy, define heel and toe, then secure the far wall first to lock orientation. Use symmetric bites with uniform spacing, maintain tension, avoid intimal catching, and seat knots without strangulation.

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From #SevenBypasses: “Infinitesimal forces drive the needle forward and the wall backward, the needlepoint pierces the tissue with a haptic “pop” that transmits through the instruments, fires the fingertips’ sensory receptors, and stimulates the faintest of perception of a bite. The needle glides through the tissue until the driver meets the microforceps to fully consume the bite. The microforceps then exits the arterial lumen, gently lifts the second wall with its fine tips, and the cycle repeats. Another collision of infinitesimal forces and another haptic pop as the needle pierces and glides and bites. With a squeeze of the microforceps and a release of the driver, the driver circles around to counter-sweep the tissue off the back end of the needle and the needle completes its bite...”
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