Study of coronary artery bypass using the PAS-Port device: assessment by multidetector computed tomography.
OBJECTIVE
The use of automatic anastomotic devices in coronary artery bypass grafting surgery is associated with lower patency rates in comparison to conventional anastomosis methods. This is thought to be caused by graft curvature occurring after closing of the chest wall.


METHODS
We evaluated 39 grafts in 28 patients who underwent off-pump coronary artery bypass surgery using the PAS-Port. After surgery, the proximal anastomotic angle of each stent, graft morphology, and patency were evaluated with axial and sagittal views.


RESULTS
The angle for the left anterior descending coronary artery segment was relatively obtuse on the left side of the ascending aorta, and the graft loop formation was not necessary. The angle for the left circumflex coronary artery segment was significantly acute for anastomosis from the upper left side of the ascending aorta. Because grafts are under the constraints of a large loop, graft length tended to become easily excessive or deficient. The angle for the right coronary artery segment was relatively obtuse. The space on the right side of the heart was so narrow that in some cases we had difficulty setting out the appropriate graft location to prevent graft curvature. No bending or stenosis was present in any graft, showing a patency rate of 100%.


CONCLUSIONS
The short-term results of coronary bypass grafting using PAS-Port are satisfactory.
Fujii
Takeshiro
T
Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Toho University, 6-11-1 Omorinishi, Ota-ku, Tokyo 143-8541, Japan. fujiit@med.toho-u.ac.jp
Watanabe
Yoshinori
Y
Shiono
Noritsugu
N
Ozawa
Tsukasa
T
Hamada
Satoshi
S
Masuhara
Hiroshi
H
Teramoto
Chikao
C
Hara
Masanori
M
Koyama
Nobuya
N
D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump / Q000295:instrumentation*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome