Published online before print July 14, 2003, doi: 10.1161/01.CIR.0000080916.84077.C0
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2003;108:452.)
© 2003 American Heart Association, Inc.
Clinical Investigation and Reports |
Clinical, Angiographic, and Interventional Follow-Up of Patients With Aortic-Saphenous Vein Graft Connectors
From the Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minn.
Correspondence to Jay H. Traverse, MD, Minneapolis Cardiology Associates, Minneapolis Heart Institute, 920 East 28th Street, Suite 300, Minneapolis, MN 55407. E-mail trave004{at}tc.umn.edu
Received February 5, 2003; revision received April 24, 2003; accepted April 25, 2003.
Background— The use of aortic connectors for proximal saphenous vein bypass graft anastomoses eliminates the need for aortic clamping during coronary artery bypass grafting (CABG) and may reduce the incidence of stroke in the elderly and in patients with severe aortic atherosclerosis.
Methods and Results— We studied 74 consecutive patients who received the Symmetry Bypass System aortic connector at the time of CABG. A total of 131 of 144 proximal vein graft anastomoses were performed with this device. The left internal mammary artery was used in 62 patients, and 61 patients had "off-pump" coronary revascularization. A total of 11 patients were readmitted with chest pain consistent with unstable angina 173±39 days after CABG. Five of the 11 patients had previous in-stent restenosis before CABG. At angiography, 20 saphenous vein bypass grafts containing 19 connectors were found to have severe stenosis (n=12) or occlusion (n=6) and were treated with angioplasty and stenting or medical therapy. Seven of 11 patients were readmitted 76±11 days later with recurrent chest pain and were found to have severe stenosis at the previously stented connector site. Six patients underwent angioplasty followed by brachytherapy. Three of these patients redeveloped chest pain and were readmitted 151±71 days later. Two patients were started on oral Rapamune, and one patient underwent redo-CABG.
Conclusion— Eleven of 74 patients who received aortic connectors at the time of CABG developed symptomatically significant stenosis or occlusion at the connector site shortly after CABG, requiring multiple repeat interventions, including brachytherapy.
Key Words: bypass • stents • restenosis • coronary disease
This article has been cited by other articles:
 |
|
 |
|
  J. D. Puskas, M. E. Halkos, H. Balkhy, M. Caskey, M. Connolly, J. Crouch, A. Diegeler, J. Gummert, W. Harringer, V. Subramanian, et al. Evaluation of the PAS-Port Proximal Anastomosis System in coronary artery bypass surgery (the EPIC trial) J. Thorac. Cardiovasc. Surg., July 1, 2009; 138(1): 125 - 132. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Puehler, S. Fraund-Cremer, J. Cremer, and A. Boening Successful six-year follow-up of a sutureless device for proximal anastomoses in a severely calcified ascending aorta Interactive CardioVascular and Thoracic Surgery, August 1, 2008; 7(4): 670 - 672. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Kempfert, U. T. Opfermann, M. Richter, T. Bossert, F. W. Mohr, and J. F. Gummert Twelve-Month Patency With the PAS-Port Proximal Connector Device: A Single Center Prospective Randomized Trial Ann. Thorac. Surg., May 1, 2008; 85(5): 1579 - 1584. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. J.L. Suyker and C. Borst Coronary Connector Devices: Analysis of 1,469 Anastomoses in 1,216 Patients Ann. Thorac. Surg., May 1, 2008; 85(5): 1828 - 1836. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Bergmann, K. Meszaros, S. Huber, P. Oberwalder, H. Machler, G. Schaffler, R. Rienmueller, and B. Rigler Forty-one-month follow-up of the Symmetry aortic connector system for proximal venous anastomosis J. Thorac. Cardiovasc. Surg., July 1, 2007; 134(1): 23 - 28. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Biancari, J. Lahtinen, R. Ojala, L. Ahvenjarvi, A. Jartti, M. Mosorin, J. Heikkinen, P. Taskinen, and M. Lepojarvi Spyder Aortic Connector System in Off-Pump Coronary Artery Bypass Surgery Ann. Thorac. Surg., July 1, 2007; 84(1): 254 - 257. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. Gummert, S. Demertzis, K. Matschke, U. Kappert, M. Anssar, F. Siclari, V. Falk, E. L. Alderman, and W. Harringer Six-Month Angiographic Follow-Up of the PAS-Port II Clinical Trial Ann. Thorac. Surg., January 1, 2006; 81(1): 90 - 96. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Kitamura, H. Okabayashi, M. Hanyu, Y. Soga, T. Nomoto, H. Johno, J. Nakano, T. Matsuo, M. Kai, and E. Umehara Early and midterm patency of the proximal anastomoses of saphenous vein grafts made with a Symmetry Aortic Connector System J. Thorac. Cardiovasc. Surg., October 1, 2005; 130(4): 1028 - 1031. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Aoki, A. T.L. Ong, A. Hoye, L. A. van Herwerden, J. E. Sousa, A. Jatene, J. J.R.M. Bonnier, J. P.M.A. Schonberger, N. Buller, R. Bonser, et al. Five year clinical effect of coronary stenting and coronary artery bypass grafting in renal insufficient patients with multivessel coronary artery disease: insights from ARTS trial Eur. Heart J., August 1, 2005; 26(15): 1488 - 1493. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. A. Frazier, F. Qureshi, K. M. Read, R. C. Gilkeson, R. S. Poston, and C. S. White Coronary Artery Bypass Grafts: Assessment with Multidetector CT in the Early and Late Postoperative Settings RadioGraphics, July 1, 2005; 25(4): 881 - 896. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Boening, F. Schoeneich, A. Lichtenberg, E. Bagaev, J. T. Cremer, and U. Klima First clinical results with a 30{degrees} end-to-side coronary anastomosis coupler Eur. J. Cardiothorac. Surg., May 1, 2005; 27(5): 876 - 881. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Dietrich, S. Martens, M. Kohlert, C. Herzog, M. F. Khan, G. Wimmer-Greinecker, and A. Moritz Decreased intermediate term patency of automated proximal anastomoses evaluated by sequential ultrafast CT Eur. J. Cardiothorac. Surg., April 1, 2005; 27(4): 579 - 583. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Wiklund, L.F. Bonilla, and E. Berglin A new mechanical connector for distal coronary artery anastomoses in coronary artery bypass grafting: A randomized, controlled study J. Thorac. Cardiovasc. Surg., January 1, 2005; 129(1): 146 - 150. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Matschke, U. Kappert, and J. Schneider Graft Occlusion After Deployment of the Aortic Connector Symmetry System: Is Anticoagulation a Necessity? Ann. Thorac. Surg., November 1, 2004; 78(5): 1878 - 1878. [Full Text] [PDF]
|
|
|
|
|
|
O. Reuthebuch, A. Kadner, and M. I. Turina Reply Ann. Thorac. Surg., November 1, 2004; 78(5): 1878 - 1879. [Full Text] [PDF]
|
|
|
|
|
|
B. Medalion, D. Meirson, E. Hauptman, L. Sasson, and A. Schachner Initial experience with the Heartstring proximal anastomotic system J. Thorac. Cardiovasc. Surg., August 1, 2004; 128(2): 273 - 277. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Redaelli, F. Maisano, G. Ligorio, E. Cattaneo, F.M. Montevecchi, and O. Alfieri Flow dynamics of the St Jude Medical Symmetry aortic connector vein graft anastomosis do not contribute to the risk of acute thrombosis J. Thorac. Cardiovasc. Surg., July 1, 2004; 128(1): 117 - 123. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Farhat, L. Chalabreysse, C. Diab, S. Aubert, and O. Jegaden Histological aspects of the saphenous vein damage with the use of the symmetry(R) aortic connector system Interactive CardioVascular and Thoracic Surgery, June 1, 2004; 3(2): 373 - 375. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Martens, M. Dietrich, C. Herzog, M. Doss, G. Schneider, A. Moritz, and G. Wimmer-Greinecker Automatic connector devices for proximal anastomoses do not decrease embolic debris compared with conventional anastomoses in CABG Eur. J. Cardiothorac. Surg., June 1, 2004; 25(6): 993 - 1000. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Okada, T. Sueda, K. Orihashi, and K. Imai Early type A dissection with the aortic connector device Eur. J. Cardiothorac. Surg., May 1, 2004; 25(5): 902 - 904. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. J. Cavendish, W. F. Penny, M. M. Madani, S. Keramati, O. Ben-Yehuda, D. G. Blanchard, E. Mahmud, A. Perricone, and S. Tsimikas Severe ostial saphenous vein graft disease leading to acute coronary syndromes following proximal aorto-saphenous anastomoses with the symmetry bypass connector device: Is it a suture device or a "stent"? J. Am. Coll. Cardiol., January 7, 2004; 43(1): 133 - 139. [Abstract] [Full Text] [PDF]
|
|