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J Thorac Cardiovasc Surg 2003;125:414-417
© 2003 The American Association for Thoracic Surgery

Brief Communications

First experience with the St Jude Medical, Inc, Symmetry Bypass System (Aortic Connector System)

From the Department of Thoracic and Cardiovascular Surgery^a and the Department of Cardiology,^b Heart Center North Rhine-Westfalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany.

Received for publication April 3, 2002. Accepted for publication May 30, 2002. Address for reprints: Lech Hornik, Heart Center North Rhine-Westphalia, Department of Thoracic and Cardiovascular Surgery, Georgstrasse 11, Bad Oeynhausen North Rhine-Westphalia 32545, Germany.

The first 20% of the full text of this article appears below.

View larger version (117K): [in this window] [in a new window]   Tenderich and Hornik (left to right).

If atheroma or calcification of the aortic wall are present, clamping is often impossible, and it remains unclear whether the use of the partial occlusion clamps on the pulsating aorta during off-pump surgery will increase the risk of iatrogenic injuries.

However, the St Jude Medical, Inc, Symmetry Bypass System (Aortic Connector System [ACS]) presents an alternative way of creating the proximal anastomosis of saphenous vein grafts. ² It avoids aortic bite clamping and reduces the need for aortic manipulation.

Patients and methods

Between April and October 2001, 69 of 70 proximal anastomoses were consecutively performed in 45 patients aged 36 to 89 years (mean, 68.3 years) by using the ACS. Eighteen internal thoracic artery grafts, 70 autologous vein grafts, and 1 radial artery graft were used, for a total number of 108 peripheral anastomoses with an average of 2.4 anastomoses per patient. Five patients were operated on in a conventional manner with the heart-lung machine. Of 31 off-pump patients, 9 patients had to be switched to on-pump therapy, with a conversion rate of 29%.

In 4 patients with postoperatively de novo angina pectoris, coronary angiography was indicated, showing severe stenosis of the proximal anastomoses in each case.

In all cases the . . . [Full Text of this Article]

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