Five-Year Clinical Outcome and Patency Rate of Device-Dependent Venous Grafts After Clampless OPCAB with PAS-Port Automated Proximal Anastomosis: The PAPA Study

Abstract

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.

Patency of Saphenous Vein Grafts Using the PAS-Port System During Coronary Artery Bypass Surgery

“…All of the other target sites had patency rates higher than 80%. These results are comparable to previous reports [6][7][8][9][10][11][12].…”

“…Demertzis and colleagues [9] reported a 6-month PAS-Port patency of 88% for 86 patients with 101 PAS-Port implants. Bassano and colleagues [6] evaluated the long-term PAS-Port devicedependent SVG patency in 156 patients with 169 devices. The noncumulative actual patency rate was 90%, 85%, 84%, 84%, and 93% for grafts that were 1, 2, 3, 4, and 5 years old, respectively.…”

Devices for a Clampless Approach to Coronary Artery Operations: Effect on Stroke Rate

“…We have had a similar positive experience with a different device for constructing proximal anastomoses on the aorta, preserving a clampless approach: the proximal aortosaphenous anastomosis PAS-port automatic connector (Cardica Inc., Redwood City, CA). In our recently published PAPA study of 152 consecutive patients who underwent clampless off-clamp coronary artery bypass (OPCAB) with at least one venous graft (165 proximal aortic anastomoses and 199 device-dependent distal anastomoses), we recorded no stroke at all [2]. The device seemed to be reliable in terms of long-term patency rate (92% actual patency rate in 5-year old venous grafts).…”

“…First, in our original study [2], the liberal arm had a target glucose range of 121-180 mg/dL, based on Society of Thoracic Surgeons guidelines. Our approach to glucose control has changed from a more strict target range (90-120 mg/dL) to this more liberal range as a result of the study.…”

“…We thank Dr Bassano and colleagues for their editorial letter [1] and are aware of their prior reports using the PAS-Port device [2]. At Emory, we have had an interest in non-cross-clamp techniques for proximal coronary anastomotic devices during coronary artery bypass grafting (CABG) and participated in the EPIC trial [3] evaluating the PAS-Port device.…”