Intraoperative and intermediate-term angiographic results of coronary artery bypass surgery with Symmetry proximal anastomotic device.
OBJECTIVE
The objective of this study was to investigate the patency in saphenous vein coronary bypass grafts in which the proximal anastomoses were performed with automatic connector devices or with a traditional suture technique.


METHODS
Forty-six patients underwent coronary artery bypass grafting without cardiopulmonary bypass by using one thoracic graft and one or more saphenous vein grafts. Grafts were attached to the aorta with a Symmetry connector (St Jude Medical, Inc, St Paul, Minn) in 23 patients, and partial occlusion of the aorta and sutured anastomoses were used in 23 other patients. Grafts were studied intraoperatively with transit time flowmetry and angiography and revised if necessary. Angiography was repeated after 3 to 5 months.


RESULTS
Intraoperative graft patency did not differ between the 2 groups. Follow-up angiography demonstrated excellent thoracic graft patency. Vein graft patency decreased to 50% in the Symmetry group, whereas it was 90% in the suture group ( P = .01). Twenty-five percent of the Symmetry grafts had significant stenosis in the connector.


CONCLUSIONS
Saphenous vein grafts anastomosed to aorta with the Symmetry proximal connector have low intermediate patency compared with those with traditionally sutured anastomoses. We do not recommend the routine use of this device in coronary artery bypass operations.
Bergsland
Jacob
J
Interventional Center, Rikshospitalet, Oslo, Norway. nielsb@aol.com
Hol
Per Kristian
PK
Lingås
Per Snorre
PS
Lundblad
Runar
R
Rein
Kjell Arne
KA
Andersen
Rune
R
Mørk
Bjørn Erik
BE
Halvorsen
Steinar
S
Mujanovic
Emir
E
Kabil
Emir
E
Svennevig
Jan L
JL
Fosse
Erik
E
D000368:Aged; D000714:Anastomosis, Surgical / Q000295:instrumentation; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000295:instrumentation*; D004864:Equipment and Supplies / Q000009:adverse effects*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011184:Postoperative Period; D012501:Saphenous Vein / Q000503:physiopathology / Q000637:transplantation; D013536:Suture Techniques; D016896:Treatment Outcome; D014654:Vascular Patency