title: Skeletonized radial artery graft with the St. Jude Medical Symmetry Bypass System (aortic connector system).
abstract: BACKGROUND
  We report our initial experience with an automatic anastomotic device using skeletonized radial artery in patients requiring off-pump coronary artery bypass grafting (CABG).
  
  
  METHODS
  St. Jude Medical, Inc, Symmetry Bypass System (aortic connector system [ACS]) (St Jude Medical, St. Paul, MN) was used in ten patients. Ten consecutive patients who underwent off-pump CABG and who received at least one radial artery graft proximal anastomosis using the ACS were evaluated. The radial artery (RA) was harvested in a skeletonized fashion and applied to the ACS in the same manner as applying saphenous vein graft. The creation of the anastomosis lasted no longer than a few seconds.
  
  
  RESULTS
  Our attempt to use the ACS for proximal anastomosis of the RA was successful in all ten patients. Mean operating time was 3.2 +/- 0.6 minutes and an average of 3.0 +/- 0.9 bypass grafts (range, 2 to 5 grafts) were performed. There was no postoperative fatal complication. Postoperative angiographic control showed that all grafts were widely patent including grafts other than the RA. During the mean postoperative follow-up of 10.3 +/- 2.9 months, there was no cardiac-related event in any patient.
  
  
  CONCLUSIONS
  The St. Jude Medical Symmetry aortic connector system allows the construction of uniform and widely patent anastomoses in RA graft and does not require aortic side biting. Skeletonization of the RA is a safe and effective technique for applying ACS in off-pump CABG using multiple arterial grafts.
authors.affiliation: Department of General and Cardiothoracic Surgery, Kanazawa University School of Medicine, School of Medicine, Takaramachi, Kanazawa, Japan. go@med.kanzawa-u.ac.jp
authors.forename: Go
authors.initials: G
authors.lastname: Watanabe
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Takemura
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Tomita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nagamine
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kamiya
authors.forename: Taro
authors.initials: T
authors.lastname: Kanamori
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000295:instrumentation*; D001026:Coronary Artery Bypass / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D017534:Radial Artery / Q000637:transplantation*; D020858:Tissue and Organ Harvesting