Objective
To evaluate long‐term clinical performance and angiographic patency of automated proximal venous anastomoses following clampless coronary artery bypass (C‐CAB).
Methods
Observational study in patients submitted for isolated C‐CAB and at least one proximal aortosaphenous anastomosis performed with an automated connector (Cardica PAS‐Port®) including 152 consecutive patients (165 devices and 199 device‐dependent distal anastomoses), with LVEF > 30% and saphenous vein diameter of 4–6 mm. Clinical follow‐up was 96% complete (4101/4269 pt‐months). Graft patency rate was assessed with 64‐slice CT‐scan or coronary angiography. Freedom from major adverse cardiac and cerebrovascular events (MACCE) was reported as actuarial probability with 95% confidence limits and venous graft patency as actual rate at every year interval.
Results
Early operative mortality was 1.9%; incidence of neurologic injury was zero. Freedom from MACCE was 92.7 ± 2.1 at one year and 85.2 ± 4.8 at five years. The actual patency rate of device‐dependent venous grafts was 90%, 85%, 84%, 84%, and 93% for one‐, two‐, three‐, four‐, and five‐year‐old grafts, respectively.
Conclusions
The device is a well‐performing system for proximal anastomoses. The incidence of neurologic complications seems to be reduced with this clampless approach. The high patency rate is stable over time. doi: 10.1111/jocs.12274 (J Card Surg 2014;29:325–332)