Objective: The PAS-Port(TM) System allows for the rapid connection of a vein graft with the aorta via a stainless steel implant without aortic clamping. After promising initial experience we adopted the PAS-Port(TM) system for all patients (pts) in whom aortic site clamping was not desired. Considering that in the past facilitated anastomoses were a cause of concern, as high occlusion rates were reported after use of a nitinol connector, we opted for a clinical and imaging control of the first 100 pts. This communication summarizes the mid-term results 6 months after surgery.
Methods: A total of 100 consecutive patients (pts), 86 males, 14 females, (mean age 68.9±12 yrs) underwent coronary bypass artery grafting with at least one PAS-Port(TM) anastomosis. So far 70 pts were followed up clinically and by means of multi-slice CT at 6 months after surgery. MACCE (major adverse cardiac and cerebral events) incidence and graft patency were determined.
Results: In 54 pts (54%) the procedure was elective, in 46 pts (46%) urgent or emergent, 5 procedures (5%) were redos. Overall early mortality was 4%. In 69 pts (69%) surgery was performed off-pump, in 11 pts (11%) on a beating heart on pump and in 12 pts on an arrested heart. Mean number of distal anastomoses was 3.5±0.8 / pt. Proximal anastomoses were configured in 62 pts (62%) as separate anastomoses, in 38 pts (38%) as T-grafts originating off a PAS-Port (TM) graft. At 6 months PAS-Port (TM) dependent vein graft patency was 86%, LIMA patency was 99%, patency of the radial artery was 83%. Overall incidence of MACCE at 6 months was 5.3% (no deaths, 1 intraoperative myocardial infarction and 2 PTCAs for recurrent angina, all not implant dependent).
Conclusions: The PAS-Port (TM) System allows for a safe and reproducible proximal vein graft anastomosis resulting in good mid-term patency and a low incidence of MACCE.