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Graft fixation with a side graft holder for sequential and composite graft anastomosis in coronary artery bypass surgery

Department of Cardiovascular Surgery, Saitama City Hospital, 2460 Mimuro, Midoriku, Saitama City, Saitama 336-8522, Japan

*Corresponding author. Tel.: +81-48-873-4111; fax: +81-48-873-7982.

E-mail address: shimasantamerry{at}tulip.ocn.ne.jp (Y. Shimamura).

The purpose of this study was to assess the feasibility and effectiveness of graft fixation with a novel side graft holder for sequential or composite graft anastomosis in coronary artery bypass grafting (CABG). Records of 34 patients who underwent CABG using sequential or composite graft anastomosis technique were reviewed. The device was used on 47 anastomoses (sequential=43; composite graft=4). Excellent fixation and visualization of the graft was obtained in all patients without graft injury. Postoperative angiographic patency rate of distal anastomoses was 95.2% (arterial, 91.2%; venous, 96.7%). All sequential and composite graft anastomoses were patent and without stenosis. One operative death occurred due to low cardiac output after emergent CABG for acute myocardial infarction. No elective patient died during hospitalization. Postoperative complications occurred in two patients (ventricular fibrillation, 1; postoperative catheter intervention, 1). No perioperative myocardial infarctions or re-operations occurred. Our clinical experience shows that graft fixation with the device is safe, reliable, and effective for sequential and composite graft anastomosis during CABG.

Key Words: Coronary artery bypass grafting; Anastomosis; Surgical instruments