title: Patency outcomes of aortic connectors.
abstract: OBJECTIVE
  : Controlled outcome analysis of mechanical aortic connectors for proximal saphenous vein bypass graft anastomosis is lacking. We report the clinical and angiographic outcome of patients receiving the Symmetry aortic connector (St. Jude Medical, Inc St. Paul, MN, US) within a multicenter, prospective, randomized study.
  
  
  METHODS
  : Twenty-five patients at 3 study sites received aortic connectors at the time of coronary artery bypass surgery. Protocol-defined angiographic follow-up was completed in 19 of 25 patients (76%) at time-points up to 14 months postoperatively; 32 connector anastomoses were evaluated in these 19 patients. Beating heart surgery was performed in 17 patients, and 2 were performed with cardiopulmonary bypass. Age was 69.7 ± 8.1 year; all patients were males.
  
  
  RESULTS
  : The connector anastomosis patency rate was 15.6% (5/32). There were no deaths during the follow-up period. Four patients (21%) suffered myocardial infarction and 2 additional patients (10.5%) required percutaneous coronary interventions; one of who required 3 percutaneous coronary interventions, the other received one percutaneous coronary intervention.
  
  
  CONCLUSIONS
  : In this nonrandomized cohort of patients, occlusion rate with Symmetry connectors was significantly greater than anticipated. Patients who have received these connectors during coronary artery bypass surgery may require closer follow-up and evaluation. While the manufacturer has stopped producing this device, there has been no recall of the product, clinical support remains ongoing, and next generation connectors have now been marketed. Consideration should be given to discontinuation of the clinical use of Symmetry connectors.
authors.affiliation: *Veterans Affairs Cooperative Studies Program Coordinating Center, VA Maryland, Healthcare System, Perry Point, MD and University of Maryland School of Medicine, Department of Epidemiology and Preventive Medicine, Baltimore, MD; †VA Pittsburgh Healthcare System and Division of Cardiothoracic Surgery-University of Pittsburgh School of Medicine, Pittsburgh, PA; ‡Denver Veterans Affairs Medical Center, University of Colorado Health Sciences Center School of Medicine, Department of Medicine, Surgery, and Pathology, Cooperative Studies Program National Coordinator and Continuous Improvement in Cardiac Surgery Program, Denver, CO; §University of South Florida, Tampa General Hospital, James A. Haley Veterans Administration Hospital, Tampa, FL.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Zenati
authors.forename: Ali
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authors.lastname: Sonel
authors.forename: Brack
authors.initials: B
authors.lastname: Hattler
authors.forename: A Laurie
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authors.lastname: Shroyer
authors.forename: Joseph
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authors.lastname: Collins
authors.forename: John
authors.initials: J
authors.lastname: Messenger
authors.forename: Janet H
authors.initials: JH
authors.lastname: Baltz
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Mohr
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Gabany
authors.forename: Dimitri
authors.initials: D
authors.lastname: Novitsky
authors.forename: Frederick
authors.initials: F
authors.lastname: Grover