| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2002;74:2101-2105
© 2002 The Society of Thoracic Surgeons
a Division of Cardiovascular Surgery, "L. Sacco" Hospital, Milan, Italy
b Department of Cardiology, "L. Sacco" Hospital, Milan, Italy
Accepted for publication June 28, 2002.
* Address reprint requests to Dr Scrofani, Divisione di Cardiochirurgia, Ospedale "L. Sacco", Via G. B. Grassi n. 74, 20157 Milan, Italy.
e-mail: scrofani{at}robertomail.it
BACKGROUND: Until now technologic evolution in coronary bypass surgery has focused on extracorporeal circulation, on operation without extracorporeal circulation, and on the exposure of the operative site. Recently a one-shot anastomotic device for the proximal anastomosis in coronary surgery was developed. We investigated whether the use of the aortic connector system (ACS) could facilitate the creation of aortosaphenous vein graft anastomoses in myocardial revascularization.
METHODS: From November 2000, 40 ACS devices were used in 36 consecutive patients (mean age 70.7 ± 8.9 years); 12 patients (33.3%) underwent surgery on pump and 24 patients (66.6%) off pump; 50 distal anastomoses were performed. In all cases the connection with the ascending aorta was created before the distal anastomoses because of the necessity to slide the saphenous vein graft (SVG) over the vein transfer sheath. Intraoperative graft function was tested measuring blood flow by Doppler analysis. Postoperative evaluation of the anastomotic patency was carried out by early angiography in 34 patients (94.7%) but was excluded in 5 patients (5.3%) with extensive extracardiac vascular occlusive disease.
RESULTS: Of 38 AC (95%) evaluated, 36 (94.7%) functioned properly. The end-to-side proximal anastomosis without aortic clamping is instantaneous, the quality of anastomoses was highly rated, no additional stitches were required, and all coronary arteries could be reached. Intraoperative quantity flow was measured by Doppler analysis and all but one showed good flow. Early postoperative angiography demonstrated good patency of the grafts in all cases but 2 (5.3%). At 1-year follow-up, 1 patient died of stroke; all other patients remained free of symptoms and no reoperation was required.
CONCLUSIONS: The use of ACS makes end-to-side anastomosis rapid, effective, and reproducible while eliminating aortic cross clamping; it opens a new era in beating or nonbeating coronary surgery. Long-term results are mandatory to confirm our favorable preliminary results.
This article has been cited by other articles:
|
|
 |
|
  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]
|
|
|
|
|
|
L. G. Wolf, Y. Abu-Omar, B. P. Choudhary, D. Pigott, and D. P. Taggart Gaseous and solid cerebral microembolization during proximal aortic anastomoses in off-pump coronary surgery: The effect of an aortic side-biting clamp and two clampless devices J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 485 - 493. [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]
|
|
|
|
|
|
M. Setina, A. Krchnakova, A. Mokracek, L. Pesl, and L. F. Bonilla The Second-Generation Aortic Connector: Six Months' Angiographic Follow-Up Ann. Thorac. Surg., August 1, 2005; 80(2): 695 - 699. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Vicol, M. Oberhoffer, G. Nollert, S. Eifert, P. Boekstegers, B. Wintersperger, and B. Reichart First Clinical Experience With the HEARTSTRING, a Device for Proximal Anastomoses in Coronary Surgery Ann. Thorac. Surg., May 1, 2005; 79(5): 1732 - 1737. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Melero, C. Porras, M. Such, E. Olalla, and J. Alonso Severe Stenosis of Anastomoses by Using the Symmetry Aortic Connector System Ann. Thorac. Surg., November 1, 2004; 78(5): 1831 - 1833. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Kitamura, H. Okabayashi, M. Hanyu, J. Nakano, S. Kono, T. Nomoto, A. Nagasawa, H. Sakaguchi, H. Johno, and T. Matsuo Early Results and Problems with St. Jude Medical Symmetry Bypass System in Japan Asian Cardiovasc Thorac Ann, September 1, 2004; 12(3): 236 - 238. [Abstract] [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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
J. Lahtinen, F. Biancari, M. Mosorin, J. Heikkinen, P. Rainio, T. S. Juvonen, and M. Lepojarvi Fatal complications after use of the symmetry aortic connector in coronary artery bypass surgery Ann. Thorac. Surg., May 1, 2004; 77(5): 1817 - 1819. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
