There are two types of coronary artery bypass grafting (CABG) anastomosis methods: the end-to-side anastomosis (ESAs) and the side-to-side anastomosis (SSAs). The choice of these methods is determined by the surgeon's favor because there is no evidence how to optimize. The ultimate objective of this study is to provide new methodology for the surgeons to enable them to choose the anastomosis methods through both in-vivo and invitro tests. The in-vivo tests were performed on pigs and the energy loss at the anastomosis ESAs and SSAs were compared. The in-vitro tests were conducted in the newly-developed system to evaluate CABG anastomosis methods. This system is composed of the mock circulatory system and the coronary simulator, which originally was designed to reproduce various types of the coronary hemodynamics. Both the in-vivo and the in-vitro tests showed a similar 'tendency of the energy loss: SSAs had a lower energy loss than ESAs under the same conditions. These effects were caused by the difference in the local flow at the anastomosis between ESAs and SSAs. Consequently, SSAs is believed to be an anastomosis method preferable to ESAs.
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