Coronary anastomotic devices: theory and patented ideas on micromechanical fastening.

Coronary anastomotic devices are being designed to reduce the laborious, complex suturing approach to endoscopic coronary surgery. An anastomotic device should be safe and reliable, it should allow full view of the vessel parts to be bonded, it must provide a simple and rapid deployment, and should be hemodynamically adequate. Three anastomotic device categories found in the (patent) literature are discussed that use micromechanical fastening techniques. First, devices using individual bonding elements; second, devices using bonding elements anchored to extra-luminal frames; third, devices using an internal frame, often a stent-like structure. Anastomotic devices described in the (patent) literature to date fail to meet all requirements for endoscopic coronary application.