Background: Evolving technologies of proximal anastomosis devices meet the endeavor of surgeons to minimize manipulation of the ascending aorta during surgical myocardial revascularization. The objective of this study was to compare the patency rate of the saphenous vein coronary bypass grafts in which the proximal anastomoses were performed with automatic connector devices to the suture technique.
Methods: From September 2002 through July 2003, 86 patients underwent coronary artery bypass grafting with at least 1 vein graft anastomosed to the ascending aorta with the Symmetry G2 connector. Six-month clinical and angiographic follow-up, including Core-Lab quantitative coronary angiography (QCA) and corrected TIMI frame count (CTFC), was performed.
Results: Eighty patients had at least 1 connector successfully implanted. Freedom from MACE (cardiac mortality myocardial infarction and target vessel reintervention) was 72/80 (90%). Six patients underwent a target vessel reintervention on the connector grafts. Six-month (mean 193 ± 36 days) angiography patency rates for the connector grafts were 72/81 (88.89%), 37/40 (92.5%) in sutured grafts, and 60/62 (96.8%) in arterial grafts. By QCA, 64/65 (98.5%) patent connector-grafts were free from more than 50% stenosis (1 connector-graft with a 51% stenosis). CTFC showed 65/65 (100%) patent connector-grafts with nonrestrictive flow.
Conclusions: Saphenous vein grafts anastomosed to the aorta with the Symmetry G2 connector have early and midterm patency rates comparable to the conventional sutured anastomoses. These results support the efficiency of the second generation of symmetry aortic connectors.
*Herz und Gefaessklinik, Department of Cardiac Surgery, Bad Neustadt, Germany; †Hospital, Department of Cardiovascular Surgery, Ceske Budejovice, Czech Republic; ‡Department of Cardiac Surgery, University of Milan, Centro Cardiologico Milan, Italy; §Clinic for Cardiovascular Surgery, University Hospital, Bern, Switzerland; ‖Perfuse Core Laboratories and Data Coordinating Center, Boston, MA; ¶Division of Cardio-Thoracic Surgery, Mayo Clinic, Rochester, MN.
This study received financial support from St. Jude Medical Inc.
Address correspondence and reprint requests to Dr. Anno Diegeler, Abtl. Herzchirurgie, Herz-und Gefäßklinik Bad Neustadt, Salzburger Leite 1, D-97616 Bad Neustadt-Germany; e-mail: firstname.lastname@example.org.