Benham JJ1*, Perkins L1, Sun B2, Gross C3 and Rapoza R1
1Abbott Vascular, 3200 Lakeside Drive, Santa Clara, USA
2Minneapolis Heart Institute, 800 E 28th St., Minneapolis, USA
3American Preclinical Services, 8945 Evergreen Blvd., Minneapolis, USA
It is not well understood how Percutaneous Coronary Intervention (PCI) with permanent metallic stents complicates an impending Coronary Artery Bypass Grafting (CABG) procedure. However, previously implanted metallic stents often limit the graft landing zone options. Due to their transient properties, Bioresorbable Vascular Scaffolds (BVS) may address this issue and allow for the implanted site to serve as a suitable grafting location. The aim of this study was to acutely evaluate this hypothesis. The Left Anterior Descending (LAD) coronary arteries of three healthy Yucatan miniswine were implanted with 3.0 mm × 12 mm BVS. At one year post implant, a CABG procedure was performed within the BVS implanted segment. Procedural feedback was obtained from the cardiothoracic surgeon. Patency of the graft and artery was assessed with standard angiography and intravascular with Optical Coherence Tomography (OCT). The animals were sacrificed immediately post procedure and the BVS implanted segment with graft and the downstream myocardium were assessed histologically. The procedure was similar to performing an incision in a mildly-moderately diseased vessel but was not like a calcified vessel. Post-graft imaging revealed patent arteries with no evidence of thrombosis, embolization, or luminal obstruction due to the scaffold struts. Histology confirmed that the graft was within the BVS implanted region, confirmed the imaging results, and demonstrated there were no adverse effects from cutting through the scaffold.
Benham JJ, Perkins L, Sun B, Gross C, Rapoza R. Coronary Artery Bypass Grafting in a Bioresorbable Vascular Scaffold Implanted Porcine Coronary Artery. Clin Surg. 2017; 2: 1809.