1. Improving CABG Surgery
Amir Durrani
Ben Hoagland
Santosh Tumkur
Lucas Burton
Advisor: Thomas P. Ryan, Ph.D.

2. Project Goals Improve harvested vessel attachment
Design device to aid in grafting
Reduce suturing difficulty
Improve local stabilization

3. Overview of Off-Pump CABG
Coronary Artery Bypass Graft
Procedure to introduce increased blood flow to occluded coronary arteries
Harvested vessels grafted to coronary arteries

4. Market Potential
150,000 Off-pump CABG surgeries performed worldwide each year
Charge for a CABG procedure ranges from $37,000 and $72,000 per case
$26 Billion spent per year on CABG surgeries
Use of beating heart techniques has grown more than 40% each year since 1997

5. Problems Stabilization is required to perform CABG on a beating heart
Effective vessel-artery contact is imperative
Complex suturing techniques required
Current stabilizers don’t provide adequate local stabilization of graft site
Heart positioning problems
Heart hemodynamics

6. Device Development

7. Surgical Dimensions Coronary artery diameter(interior) – ~1-3mm
Harvested vessel diameter(interior) – ~2-4mm
Base plate length – ~14mm
Shaft length - ~10mm

8. Device Version 1
Shaft inserted into vessel that is to be grafted and secured
Device will then be inserted into the coronary artery; folding of base allows for easy insertion
Device will adhere to the coronary artery when the upper surface of the base, containing an adhesive, is brought in contact with the upper inside surface of the coronary artery. 

9. Device Version 1 (cont.)
The two vessels are now stabilized in close contact with one another and can be easily sutured together. 
Alternative method of anastomosis would involve application of bio-adhesive to the upper surface of the elliptical base       

10. Stabilizer Improvement
Modification to suction stabilizer
Provides improved lateral stabilization
Analogous to car-jack
Spreads tissue up to one centimeter

11. Adhesive Will replace sutures (or reduce number needed)
Comprised of cross-linked proteinaceous material
High strength
Strong rapid bonding between tissues
Strong rapid bonding between tissue and synthetic materials
Stronger than conventional fibrin adhesives

12. Adhesive Composition Cross-linking on a surface
Water soluble proteinaceous material (27-53% by weight)
Di- or polyaldehydes (weight ratio: 1 part to every parts of protein
Water insoluble rubbery or leathery proteinaceous solids (free of aldehydes)
Tear strength of at least 75 g/cm^2

13. Plastics for Vessel Connector
Encourage epithelialization
Polyurethanes
Expanded Teflon
Prolene (polypropelene)
Research into catheter plastics

14. Progress Made Solidified sutureless anastamosis device
Began initial DesignSafe™ Analysis
Consulted industry mechanical engineer about stabilizer foot design
Contacted Ethicon’s principle materials engineer

15. Current Status
Using SolidWorks™ 2001Plus and SolidEdge™ 2002 to model vessel connector for prototyping purposes
Seeking feedback from Dr.’s Greelish and Merrill regarding our solutions
Prototyping the stabilizer foot design

16. Future Plans Continue developing prototypes Refine possible solutions
Continue consultation with surgeons and engineers for feedback
Alter design based on feedback and prototype test results