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J Thorac Cardiovasc Surg 2005;130:1028-1031
© 2005 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Early and midterm patency of the proximal anastomoses of saphenous vein grafts made with a Symmetry Aortic Connector System

Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyusyu City, Fukuoka, Japan.

Received for publication March 17, 2005; revisions received May 22, 2005; accepted for publication May 22, 2005.

^_* Address for reprints: Hideki Kitamura, MD, Cardiovascular Surgery, Kokura Memorial Hospital, Kifunemachi 1-1, Kokurakitaku, Kitakyusyu City, Fukuoka, 802-8555, Japan. (Email: k-hideki{at}sc4.so-net.ne.jp).

OBJECTIVE: The purpose of this study was to investigate (1) the early and midterm patency rates in saphenous vein grafts that were anastomosed with the Symmetry Aortic Connector System (St Jude Medical, Inc, St Paul, Minn) and (2) risk factors for graft occlusion.

METHODS: Thirty-one patients underwent off-pump coronary artery bypass grafting for proximal saphenous vein graft anastomoses with the aortic connector system. Intraoperative graft flow was studied with transit time flowmetry, and angiography was performed before discharge in 29 cases. Midterm (at least 1 year after the operation) saphenous vein graft patency was assessed by coronary angiography or 3-dimensional coronary computed tomography in 27 cases.

RESULTS: Postoperative angiography demonstrated a 100% patency rate and no significant stenosis at the connector-anastomosed sites. The 1-year patency rate of the saphenous vein grafts with the aortic connector system was 92.6%, with 2 cases of saphenous vein graft occlusion. Both of these cases had low graft flow and poor left ventricular function documented during the operation.

CONCLUSION: Once surgical errors had been ruled out, the 1-year patency rate of proximal saphenous vein grafts anastomosed with the aortic connector system was favorable. Poor left ventricular function and low graft flow during the operation were risk factors for midterm graft occlusion. Selection of the target vessel and its runoff may also be an important determinant of long-term patency.

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