J Korean Med Sci.  2006 Oct;21(5):849-853. 10.3346/jkms.2006.21.5.849.

Mid-Term Follow Up of Patients Using The St. Jude Medical Aortic Connector System for Proximal Vein Graft in CABG

• Chung CH
• Lee JW
• Kang JK
• Song H
• Choo SJ
• Song MG

• KMID: 1781904
• DOI: http://doi.org/10.3346/jkms.2006.21.5.849

Abstract

The aortic connector system may reduce stroke during proximal venous anastomosis. However, the overall anastomotic patency rate has been generally reported to be low. From October 2002 to March 2004, 68 patients who received proximal anastomosis using the St. Jude Aortic Connector System were included in the study. There were 47 men and 21 women and their mean age was 65.68+/-6.68 yr old (52 to 85 yr). Grafts were evaluated by coronary angiography or multi-slice 16 channel 3-D CT at 6 days and at 6 months postoperatively. In the immediate postoperative period, no stenosis was observed by either angiography (n=22) or 3D CT (n=46). At 6-month postoperatively, we performed either angiography (n=7) or 3-D CT (n=52). Of these patients, 5 patients showed graft stenosis in the midportion, and 3 in the ostium. There were no stroke. Simple, and effective proximal anastomosis with good protection from cerebrovascular accident was achieved especially when calcification or atheromatous plaque was observed at the ascending aorta in the operation room. However, our mid term patency results raise concerns related to venous graft stenosis in the midportion. Therefore, longer follow up is recommended.

Keyword

Coronary Artery Bypass; Aortic Connector System; Graft Stenosis

MeSH Terms

Saphenous Vein/*transplantation
Middle Aged
Male
Humans
Follow-Up Studies
Female
Coronary Artery Bypass/*instrumentation
Aorta/*surgery
Anastomosis, Surgical/*instrumentation
Aged, 80 and over
Aged

Figure

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  Fig. 1 Serial images of 3-D CT at immediate and 6-months postoperatively in 65-yr old man. Note the patent saphenous vein including aortic connector site (A) and the severe stenosis in the midportion of the saphenous vein (arrow) (B). But proximal site is widely patent.

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  Fig. 2 Immediate postoperative coronary angiogram (A) shows patent graft, whereas diffuse, but very mild narrowing in the mid-portion of graft is observed 6 months later on follow-up image (B).

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  Fig. 3 Severe proximal ostial graft narrowing is observed on 6-month follow-up images of a 75 yr old man (B), which is contrast to Fig. 1, 2 in that other portion of the graft is saved. However it was widely patent at the previous study (A).

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