Experience with the use of the heartstring device for proximal anastomosis in 1,720 patients undergoing off-pump coronary

Aim: to evaluate the early outcomes of using the Heartstring device for proximal anastomosis formation in patients undergoing isolated off-pump coronary artery bypass grafting (CABG).
Materials and Methods: a retrospective analysis was performed in 1,720 patients operated on between 2009 and 2022. Demographic characteristics, intraoperative variables, and early postoperative outcomes were assessed. All procedures were performed without cardiopulmonary bypass, using the Heartstring device for proximal anastomoses. The incidence of stroke, perioperative myocardial infarction, bleeding requiring reexploration, and in-hospital mortality was analyzed.
Results: the median age of patients was 63 (58–69) years; 88.3% were men. Aortic atheromatosis was detected in 54.3% of cases. The median operative time was 155 (135–180) minutes; conversion to cardiopulmonary bypass was required in 0.6% of patients. The incidence of perioperative myocardial infarction was 1%, stroke — 1.2%, acute kidney injury — 1.6%, and re-exploration for bleeding — 1.6%. The in-hospital mortality rate was 0.9%. Use of the Heartstring device allowed safe construction of proximal anastomoses without aortic clamping, even in patients with advanced atheromatosis, resulting in low rates of neurological and hemorrhagic complications.
Conclusions: application of the Heartstring device in off-pump CABG is a reliable and safe technique that reduces the risk of stroke and other aorta-related complications. This method can be considered an effective alternative to conventional clamping techniques in patients with a high risk of atheroembolism.

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