Successful six-year follow-up of a sutureless device for proximal anastomoses in a severely calcified ascending aorta

a Department of Cardiothoracic Surgery, University Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany b Department of Cardiovascular Surgery, University Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 7, D-24105 Kiel, Germany c Department of Cardiovascular Surgery, University Giessen, Rudolf-Buchheim-Str. 7, D-35392 Giessen, Germany *Corresponding author. Tel.: +49-9419449824; fax: +49-9419449811. E-mail address : thomas.puehler{at}klinik.uni-regensburg.de (T. Puehler). Background: Aortic connector devices (ACDs) for proximal anastomoses of vein grafts during coronary artery bypass grafting (CABG) have widely failed during recent years. As a consequence ACDs have been withdrawn from the market. Method: We report on an 81-year-old patient who had undergone CABG for three-vessel disease. The proximal anastomosis was accomplished with an ACD (St Jude Medical) due to a highly calcified ascending aorta. Six years later the patient underwent aortic valve replacement, which offered the opportunity of visual inspection of the previous ACD anastomosis. Result: Coronary angiography demonstrated a perfectly patent ACD anastomosis with a sufficient sequential vein graft to the marginal and the postero-lateral branches. Intraoperatively, the nitinol stent of the ACD anastomosis was perfectly incorporated, and covered with a thin layer of endothelial cells. Discussion: Though poor, short- and mid-term results have led to the abandonment of ACDs, our case demonstrates a perfect anastomosis after a six-year follow-up. Key Words: Coronary artery bypass grafting (CABG); Vein graft; Anastomostic device Related Article eComment: Aortic connectors in coronary artery surgery Marco Ricci and Tomas A. Salerno Interactive CardioVascular and Thoracic Surgery 2008 7: 672. [Full Text] [PDF]