The objective of this study was to investigate the patency in saphenous vein c oronary bypass grafts in which the proximal anastomoseswere performedwith automa tic connector devices or with a traditional suture technique. Forty-six patient s underwent coronary artery bypass grafting without cardiopulmonary bypass by us ing one thoracic graft and one or more saphenous vein grafts. Grafts were attach ed to the aorta with a Symmetry connector(St Jude Medical, Inc, St Paul, Minn) i n 23 patients, and partial occlusion of the aorta and sutured anastomoses were u sed in 23 other patients. Grafts were studied intraoperatively with transit time flowmetry and angiography and revised if necessary. Angiography was repeated af ter 3 to 5 months. Intraoperative graft patency did not differ between the 2 gro ups. 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 significa nt stenosis in the connector. Saphenous vein grafts anastomosed to aorta with th e Symmetry proximal connector have low intermediate patency compared with those with traditionally sutured anastomoses. We do not recommend the routine use of t his device in coronary artery bypass operations.
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