In patients with coronary artery disease, certain blood vessels may be narrowed or blocked, requiring a stent or a bypass (also known as diversion) to restore blood flow to the heart. Bypass surgeries typically yield great results in the short to medium term, but long-term success can be hampered by the failure of the connection between the two blood vessels. During a standard bypass procedure, this connection is manually sutured by the surgeon. Now, a breakthrough technology is poised to transform coronary artery bypass surgery by eliminating the need for suturing altogether.

AMT Medical (Ede, The Netherlands) is pioneering the development of the ELANA Heart Bypass System, a minimally invasive solution that could replace traditional open-heart bypass surgery. This system is designed to eventually enable robot-assisted, keyhole surgeries that are compatible with leading surgical robots. The ELANA Heart Bypass System will allow surgeons to perform advanced coronary artery bypass grafting (CABG) using arterial grafts, rather than venous ones, through small chest incisions, without stopping the heart or using a heart-lung machine. This approach eliminates stroke risks and other complications, and also shortens postoperative recovery times, marking a stark contrast to conventional methods that require sternotomy (chest cracking), complex suturing, and prolonged recovery. Moreover, the new system aims to reduce the overall costs of CABG procedures.

The sutureless anastomosis technique used in this system incorporates a proprietary clip and an excimer laser to connect blood vessels without the need for manual suturing, ensuring precise, rapid, and consistent graft integration while reducing complications. Furthermore, when employed in a robotic setting, the system achieves more than a 50% cost reduction. This reduction is driven by shorter operating room times, decreased hospital stays (with patients able to go home within days), fewer complications, and quicker surgeon proficiency compared to traditional CABG methods. Currently, AMT Medical is focused on completing its European first-in-human trial to assess the system during open chest CABG procedures with a beating heart. The results of this trial are expected to be available by the end of 2025 and will be shared with the surgical community. With these results, AMT anticipates obtaining CE Marking by 2026 for use during open surgical CABG procedures, either through sternotomy or via minimally invasive thoracotomy (MIDCAB). In addition, clinical trials are planned to commence in the United States, both for open and robotic settings.

“By enabling same-day discharge bypass procedures, we’re not just improving outcomes – we’re redefining cardiovascular care,” said Rutger Tulleken, CEO & Co-Founder of AMT Medical. 

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