Application of actuator-driven pulsed water jet for coronary artery bypass grafting: assessment in a swine model.
Application of actuator-driven pulsed water jet for coronary artery bypass grafting: assessment in a swine model.
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致动器驱动的脉冲水射流在冠状动脉旁路移植术中的应用：在猪模型中的评估。
DOI：
10.1007/s10047-017-1008-z
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Saiki Y.
中科院分区：
文献类型：
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作者：
Suzuki T. Kawamoto S;Nakagawa A;Endo T;Tominaga T;Akiyama M;Adachi O;Kumagai K;Saiki Y.
执行器驱动的脉冲水射流（ADPJ）解剖是一种新兴的手术方法，用于解剖组织而不会对血管造成热损伤和机械损伤。我们阐明了压电 ADPJ 的机械特性，并评估了其在冠状动脉旁路移植手术中的实用性和安全性。评估了输入电压 (10–100 V) 和脉冲水射流峰值压力之间的关系。测量猪内胸动脉和冠状动脉以及周围组织的组织强度，以确保组织选择性解剖。通过传统的电烧灼和水射流在四只猪身上采集胸内动脉，并尝试用水射流暴露心肌包围的八根冠状动脉。对解剖的标本进行组织学评估。脉冲水射流的峰值压力与输入电压呈正相关(R2= 0.9984,P< 0.001)。靶血管（胸内动脉和冠状动脉）与周围组织的断裂强度存在显着差异（分别为P= 0.002和P< 0.001）。组织学检查显示，与电烧灼相比，使用脉冲水射流（P= 0.002）分离胸内动脉，热损伤较小，并且解剖冠状动脉也没有明显的组织学损伤。 ADPJ 有可能确保胸廓内动脉和冠状动脉之间的组织选择性。结果还表明，使用 ADPJ 可以增强冠状动脉旁路移植术期间采集移植物的安全程序。
Actuator-driven pulsed water-jet (ADPJ) dissection is an emerging surgical method for dissecting tissue without heat and mechanical injury to vessels. We elucidated the mechanical properties of the piezo ADPJ and evaluated its usefulness and safety in coronary artery bypass grafting procedures. The relationship between the input voltage (10–100 V) and peak pressure of the pulsed water jet was evaluated. The tissue strengths of swine internal thoracic and coronary arteries and the surrounding tissues were measured to assure tissue-selective dissection. Internal thoracic arteries were harvested by conventional electric cautery and the water jet in four swine, and eight coronary arteries surrounded by myocardium were attempted to be exposed with the water jet. The dissected specimens were histologically evaluated. The peak pressure of the pulsed water jet was positively correlated with the input voltage (R2= 0.9984,P< 0.001). The breaking strengths of the target vessels (internal thoracic and coronary arteries) and the surrounding tissues were significantly different (P= 0.002 andP< 0.001, respectively). Histologic examination revealed that internal thoracic arteries were isolated with less heat damage using the pulsed water jet (P= 0.002) compared with electric cautery, and coronary arteries also were dissected without apparent histologic damage. ADPJ has the possibility of assuring tissue selectivity among the internal thoracic and coronary arteries. The results also indicated that the use of ADPJ may enhance safe procedures to harvest grafts during coronary artery bypass grafting.