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J Thorac Cardiovasc Surg 2004;128:718-723
© 2004 The American Association for Thoracic Surgery

Cardiopulmonary support and physiology

Intraoperative and intermediate-term angiographic results of coronary artery bypass surgery with Symmetry proximal anastomotic device

^a Interventional Center, Rikshospitalet, Oslo, Norway,
^b Department of Thoracic Surgery, Rikshospitalet, Oslo, Norway
^c Department of Radiology, Rikshospitalet, Oslo, Norway
^d Department of Anaestesiology, Rikshospitalet, Oslo, Norway

Read at the Eighty-fourth Annual Meeting of The American Association for Thoracic Surgery, Toronto, Ontario, Canada, April 25-28, 2004.

Received for publication April 20, 2004; revisions received June 26, 2004; accepted for publication July 8, 2004.

^* Address for reprints: Jacob Bergsland, MD, The Interventional Center, Rikshospitalet, Oslo, Norway (E-mail: nielsb{at}aol.com).

OBJECTIVE: The objective of this study was to investigate the patency in saphenous vein coronary bypass grafts in which the proximal anastomoses were performed with automatic connector devices or with a traditional suture technique.

METHODS: Forty-six patients underwent coronary artery bypass grafting without cardiopulmonary bypass by using one thoracic graft and one or more saphenous vein grafts. Grafts were attached to the aorta with a Symmetry connector (St Jude Medical, Inc, St Paul, Minn) in 23 patients, and partial occlusion of the aorta and sutured anastomoses were used in 23 other patients. Grafts were studied intraoperatively with transit time flowmetry and angiography and revised if necessary. Angiography was repeated after 3 to 5 months.

RESULTS: Intraoperative graft patency did not differ between the 2 groups. Follow-up angiography demonstrated excellent thoracic graft patency. Vein graft patency decreased to 50% in the Symmetry group, whereas it was 90% in the suture group (P= .01). Twenty-five percent of the Symmetry grafts had significant stenosis in the connector.

CONCLUSION: Saphenous vein grafts anastomosed to aorta with the Symmetry proximal connector have low intermediate patency compared with those with traditionally sutured anastomoses. We do not recommend the routine use of this device in coronary artery bypass operations.

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