title: Analysis of the immediate outcomes of a comparative randomized study between aorto-saphenous mechanical anastomosis versus conventional anastomosis.
abstract: OBJECTIVE
  To evaluate the immediate results of mechanical aorto-saphenous anastomosis compared with conventional anastomosis.
  
  
  METHODS
  We evaluated 12 patients. The mean age ranged from 62.33 +/- 7.30 years. Of 12 patients submitted to surgery without extracorporeal circulation, 10 (83.3%) patients were male. Thirty-three proximal anastomoses were evaluated, 21 of them being performed through the conventional manner and 12 with the St. Jude Symmetry aortic connector. The time spent on anastomosis, and free flow and patency on the 4th day postoperative were analysed.
  
  
  RESULTS
  The mechanical anastomosis was successfully performed in all patients. Electrocardiographic alteration compatible with myocardial infarctation (MI) on the 2nd day postoperative was observed only in one patient. The patient was referred to angiographic restudy, becoming evident a conventional proximal anastomosis occlusion for the marginal branch. Three patients had atrial fibrillation. The average time spent to perform the mechanical anastomosis was 44.08 +/- 9.26 seconds against 3.86 +/- 0.61 minutes of the conventional anastomosis (p = 0.0022). The average blood free flow observed in the mechanical anastomosis was 302.75 +/- 82.76 mL/min versus 190.75 +/- 51.53 mL/min (p = 0.0022). In the angiographic restudy performed on the 4th postoperative day, it was detected the occlusin of three mechanical anastomosis. There was no new conventional anastomosis (p = 0.2500).
  
  
  CONCLUSIONS
  The present study showed a statistically significant superiority for mechanical anastomosis of the saphenous vein with the aorta when evaluated the blood free flow and the time to perform the anastomosis. In relation to the artery condition in the postoperative angiography, one cannot say there was statistically significant difference between the procedures studied.
authors.affiliation: Santa Casa de Misericórdia de Curitiba - PUC/PR. rodrigo.milani@sbccv.org.br
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Milani
authors.forename: Paulo Roberto Slud
authors.initials: PR
authors.lastname: Brofman
authors.forename: José Augusto Moutinho de
authors.initials: JA
authors.lastname: Souza
authors.forename: Laura
authors.initials: L
authors.lastname: Barboza
authors.forename: Maximiliano Ricardo
authors.initials: MR
authors.lastname: Guimarães
authors.forename: Alexandre
authors.initials: A
authors.lastname: Barbosa
authors.forename: Alexandre Manoel
authors.initials: AM
authors.lastname: Varela
authors.forename: Marcel Rogers
authors.initials: MR
authors.lastname: Ravagnelli
authors.forename: Francisco Maia da
authors.initials: FM
authors.lastname: Silva
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D001011:Aorta / Q000601:surgery*; D001783:Blood Flow Velocity / Q000502:physiology; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*; D011184:Postoperative Period; D012501:Saphenous Vein / Q000637:transplantation*; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency