Long-term clinical outcome of the symmetry aortic connector system in off-pump coronary artery bypass grafting.
BACKGROUND
Several short-term and midterm follow-up studies of the Symmetry aortic connector system showed controversial results. The objective of the present study was assessing the long-term clinical outcome of patients operated with the Symmetry device and to compare the results with hand-sewn control patients.


METHODS
A retrospective case-control study of 156 (46 cases, 110 controls) consecutive patients, that underwent off-pump coronary revascularization, between January 2001 and December 2004, was conducted. Study endpoints were all-cause mortality, coronary reintervention and postoperative stroke.


RESULTS
There was no difference in survival between cases and controls (89.1 vs. 82.4%, p = 0.27) after 8 years of follow-up. No significant difference could be detected between cases and controls with respect to overall long-term coronary reintervention free survival (82.6 vs. 88.9%, p = 0.41) and freedom from coronary reintervention due to proximal vein graft failure (91.3 vs. 96.3%, p = 0.24). The use of Symmetry device could not be identified as independent risk-factor of coronary reintervention due to proximal vein graft failure (p = 0.25). Furthermore, postoperative stroke rates were comparable between cases and controls (0.0 vs. 0.9%, p = 1.00).


CONCLUSIONS
This study suggests that the use of the Symmetry Bypass Connector was not associated with adverse outcome in terms of overall survival, long-term coronary reintervention free survival, freedom from reintervention due to proximal vein graft failure and postoperative stroke.
Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The Netherlands.
Niels J
NJ
Verberkmoes
M Mostafa
MM
Mokhles
M
M
Mostafa Mokhles
Sander
S
Bramer
Albert H M
AH
van Straten
Joost F
JF
ter Woorst
Jos G
JG
Maessen
Eric
E
Berreklouw
D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D018572:Disease-Free Survival; D004867:Equipment Design; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000209:etiology; D013536:Suture Techniques / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome