title: Early and midterm patency of the proximal anastomoses of saphenous vein grafts made with a Symmetry Aortic Connector System.
abstract: OBJECTIVE
  The purpose of this study was to investigate (1) the early and midterm patency rates in saphenous vein grafts that were anastomosed with the Symmetry Aortic Connector System (St Jude Medical, Inc, St Paul, Minn) and (2) risk factors for graft occlusion.
  
  
  METHODS
  Thirty-one patients underwent off-pump coronary artery bypass grafting for proximal saphenous vein graft anastomoses with the aortic connector system. Intraoperative graft flow was studied with transit time flowmetry, and angiography was performed before discharge in 29 cases. Midterm (at least 1 year after the operation) saphenous vein graft patency was assessed by coronary angiography or 3-dimensional coronary computed tomography in 27 cases.
  
  
  RESULTS
  Postoperative angiography demonstrated a 100% patency rate and no significant stenosis at the connector-anastomosed sites. The 1-year patency rate of the saphenous vein grafts with the aortic connector system was 92.6%, with 2 cases of saphenous vein graft occlusion. Both of these cases had low graft flow and poor left ventricular function documented during the operation.
  
  
  CONCLUSIONS
  Once surgical errors had been ruled out, the 1-year patency rate of proximal saphenous vein grafts anastomosed with the aortic connector system was favorable. Poor left ventricular function and low graft flow during the operation were risk factors for midterm graft occlusion. Selection of the target vessel and its runoff may also be an important determinant of long-term patency.
authors.affiliation: Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyusyu City, Fukuoka, Japan. k-hideki@sc4.so-net.ne.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Kitamura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Okabayashi
authors.forename: Michiya
authors.initials: M
authors.lastname: Hanyu
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Soga
authors.forename: Takuya
authors.initials: T
authors.lastname: Nomoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Johno
authors.forename: Jota
authors.initials: J
authors.lastname: Nakano
authors.forename: Takehiko
authors.initials: T
authors.lastname: Matsuo
authors.forename: Masashi
authors.initials: M
authors.lastname: Kai
authors.forename: Eitaro
authors.initials: E
authors.lastname: Umehara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods