Abstract
In coronary artery bypass grafting (CABG), distal graft to coronary anastomoses are currently performed with running sutures or, to a limited extent, interrupted techniques, which are more time‐consuming. The Heartflo™ anastomotic device, introduced in 2000, automates the suturing process via simultaneous delivery of ten standard polypropylene sutures through the graft and the coronary vessel wall to construct the anastomosis. Clinical testing was performed after extensive animal studies in several centers in Europe and Canada. After the foot shape of the device had been changed in conjunction with a reduction of its diameter, coronary arteries of 1.5 mm were successfully grafted. During the clinical studies and early follow‐up, no device related injuries were reported. However, as suture management was still time‐consuming with the newest versions of the device, development of automated knot tying systems or – at least – a facilitated suture management is mandatory as the next development step.