title: Intraoperative and intermediate-term angiographic results of coronary artery bypass surgery with Symmetry proximal anastomotic device.
abstract: 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.
authors.affiliation: Interventional Center, Rikshospitalet, Oslo, Norway. nielsb@aol.com
authors.forename: Jacob
authors.initials: J
authors.lastname: Bergsland
authors.forename: Per Kristian
authors.initials: PK
authors.lastname: Hol
authors.forename: Per Snorre
authors.initials: PS
authors.lastname: Lingås
authors.forename: Runar
authors.initials: R
authors.lastname: Lundblad
authors.forename: Kjell Arne
authors.initials: KA
authors.lastname: Rein
authors.forename: Rune
authors.initials: R
authors.lastname: Andersen
authors.forename: Bjørn Erik
authors.initials: BE
authors.lastname: Mørk
authors.forename: Steinar
authors.initials: S
authors.lastname: Halvorsen
authors.forename: Emir
authors.initials: E
authors.lastname: Mujanovic
authors.forename: Emir
authors.initials: E
authors.lastname: Kabil
authors.forename: Jan L
authors.initials: JL
authors.lastname: Svennevig
authors.forename: Erik
authors.initials: E
authors.lastname: Fosse
mesh_terms: 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