title: Successful six-year follow-up of a sutureless device for proximal anastomoses in a severely calcified ascending aorta.
abstract: BACKGROUND
  Aortic connector devices (ACDs) for proximal anastomoses of vein grafts during coronary artery bypass grafting (CABG) have widely failed during recent years. As a consequence ACDs have been withdrawn from the market.
  
  
  METHODS
  We report on an 81-year-old patient who had undergone CABG for three-vessel disease. The proximal anastomosis was accomplished with an ACD (St Jude Medical) due to a highly calcified ascending aorta. Six years later the patient underwent aortic valve replacement, which offered the opportunity of visual inspection of the previous ACD anastomosis.
  
  
  RESULTS
  Coronary angiography demonstrated a perfectly patent ACD anastomosis with a sufficient sequential vein graft to the marginal and the postero-lateral branches. Intraoperatively, the nitinol stent of the ACD anastomosis was perfectly incorporated, and covered with a thin layer of endothelial cells.
  
  
  CONCLUSIONS
  Though poor, short- and mid-term results have led to the abandonment of ACDs, our case demonstrates a perfect anastomosis after a six-year follow-up.
authors.affiliation: Department of Cardiothoracic Surgery, University Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany. thomas.puehler@klinik.uni-regensburg.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Puehler
authors.forename: Sandra
authors.initials: S
authors.lastname: Fraund-Cremer
authors.forename: Jochen
authors.initials: J
authors.lastname: Cremer
authors.forename: Andreas
authors.initials: A
authors.lastname: Boening
mesh_terms: D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000295:instrumentation; D001011:Aorta / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D008297:Male; D012501:Saphenous Vein / Q000637:transplantation*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency