Initial clinical experience with a new end graft holder for anastomosis in coronary surgery.
OBJECTIVE
We assessed the feasibility and effectiveness of a novel end graft holder for coronary artery bypass grafting (CABG) and evaluated anastomotic patency and early clinical results.


METHODS
The end graft holder was applied to 45 consecutive patients. Operative characteristics were off-pump CABG in 22.2%, emergency in 28.9%, and concomitant cardiac surgery in 13.3%.


RESULTS
The device was used safely without graft injury or inadequate gripping on grafts. Postoperative angiography showed that the patency rate of distal anastomosis was 96.7% (arterial, 100%; venous, 94%). All proximal aortic and composite graft anastomoses were patent without stenosis. The rate of 30-day major adverse cardiac and cerebrovascular events was 13.3% (operative deaths, 3; repeated CABG, 1; percutaneous coronary arterial intervention, 1; and cerebral infarction, 1). None of the elective patients died during hospitalization.


CONCLUSIONS
Our initial clinical experience demonstrated that the new end graft holder was safe, reliable, and effective during CABG. The excellent fixation and visualization of the graft with the device might be particularly beneficial for off-pump CABG or for teaching trainees.
Shimamura
Yoshiei
Y
Department of Thoracic Surgery, Dokkyo Medical University, Kitakobayashi 880, Mibumachi, Shimotsugagunn, Tochigi 321-0293, Japan. simamura@dokkyomed.ac.jp
Mochizuki
Yoshihiko
Y
Yamada
Yasuyuki
Y
Eda
Kunihiro
K
Shibasaki
Ikuko
I
Inoue
Yuho
Y
Saito
Fumie
F
Miyoshi
Shinichiro
S
D000368:Aged; D000714:Anastomosis, Surgical / Q000295:instrumentation; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000295:instrumentation*; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000295:instrumentation*; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000601:surgery*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency