Video-assisted multivessel revascularization through a left anterior small thoracotomy approach with the Symmetry Aortic Connector System

Semrád, Michal; Bodlák, Petr; Stříteský, Martin; Vondráček, Vladimír; Urban, Tomáš; Vyhnalová, Petra; Holm, F; Vanĕk, I

doi:10.1067/mtc.2003.79

Cited by 10 publications

(5 citation statements)

References 11 publications

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“…Kinking of the graft has been mentioned as a possible reason for the high incidence of graft occlusion with the SACS. 2,3,22 This is possible because the aortic connector is anastomosed at a 90°angle to the ascending aorta. Kinking can also be caused by an excessively long bypass graft inasmuch as, with mechanical anastomoses, unlike conventional ones, the proximal anastomosis must be created first, and so the length of the graft may be incorrectly estimated.…”

Section: Discussionmentioning

confidence: 99%

“…Results of short-and midterm follow-up studies on the patency rate of these devices are controversial, with some reports showing good results and some an incidence of graft occlusion as high as 50% with the SACS. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Long-term follow-up studies are still lacking; so far, the longest mean follow-up period was reported by Kitamura and associates 17 in October 2005. Twenty-seven SACSs were evaluated with multislice computed tomography (MSCT) by that group; the mean follow-up was 19 months and the 1-year patency rate of that mechanical device was 92.6%.…”

mentioning

confidence: 99%

“…The goal of our study was (1) to investigate the patency rates of SACS grafts over a longer time period and (2) to analyze risk factors for graft occlusion.…”

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confidence: 99%

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Forty-one-month follow-up of the Symmetry aortic connector system for proximal venous anastomosis

Bergmann

Meszaros

Huber

et al. 2007

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Forty-one-month follow-up of the Symmetry aortic connector system for proximal venous anastomosis

Bergmann

Meszaros

Huber

et al. 2007

The Journal of Thoracic and Cardiovascular Surgery

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“…[3][4][5][6] The second generation of connecting systems can safely and quickly construct the anastomosis, 7 which is especially attractive for off-pump procedures or even minimal-access CABG. 8 But acceptance of these products depends on the mid-and longterm patency rates. In this prospective, nonrandomized, multicenter study, we investigated the midterm patency rates and clinical outcome of the St. Jude Medical second-generation aortic connector (Symmetry G2).…”

mentioning

confidence: 99%

Prospective Evaluation of the St. Jude Medical Aortic Connector for Aortic-to-Autologous Vessel Graft Anastomoses

Diegeler

Šetina

Antona

et al. 2005

Innovations�(Phila)

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Background Evolving technologies of proximal anastomosis devices meet the endeavor of surgeons to minimize manipulation of the ascending aorta during surgical myocardial revascularization. The objective of this study was to compare the patency rate of the saphenous vein coronary bypass grafts in which the proximal anastomoses were performed with automatic connector devices to the suture technique. Methods From September 2002 through July 2003, 86 patients underwent coronary artery bypass grafting with at least 1 vein graft anastomosed to the ascending aorta with the Symmetry G2 connector. Six-month clinical and angiographic follow-up, including Core-Lab quantitative coronary angiography (QCA) and corrected TIMI frame count (CTFC), was performed. Results Eighty patients had at least 1 connector successfully implanted. Freedom from MACE (cardiac mortality myocardial infarction and target vessel reintervention) was 72/80 (90%). Six patients underwent a target vessel reintervention on the connector grafts. Six-month (mean 193 ± 36 days) angiography patency rates for the connector grafts were 72/81 (88.89%), 37/40 (92.5%) in sutured grafts, and 60/62 (96.8%) in arterial grafts. By QCA, 64/65 (98.5%) patent connector-grafts were free from more than 50% stenosis (1 connector-graft with a 51% stenosis). CTFC showed 65/65 (100%) patent connector-grafts with nonrestrictive flow. Conclusions Saphenous vein grafts anastomosed to the aorta with the Symmetry G2 connector have early and midterm patency rates comparable to the conventional sutured anastomoses. These results support the efficiency of the second generation of symmetry aortic connectors.

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“…3 e 4). Questo accesso viene utilizzato anche in chirurgia cardiaca (rimozione di pacemakers infetti, chirurgia della valvola aortica e mitralica, rivascolarizzazione miocardica, reinterventi) in pazienti in cui sia indicato evitare la sternotomia [6][7][8][9][10].…”

Section: Minitoracotomia Videoassistitaunclassified

Accessi “Open” Videoassistiti in Chirurgia Toracica

Lavini

Chirurgia Toracica Videoassistita

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PremesseLa videotoracoscopia è nata all'inizio degli anni 90 del secolo scorso quando, sull'onda del successo della videolaparoscopia, si è iniziato ad eseguire interventi videoassistiti anche in chirurgia toracica. I vantaggi di questa metodica sono subito apparsi evidenti grazie alla visione intraoperatoria magnificata, alla mininvasività, all'ottima tolleranza, al pregevole risultato estetico.Gli aspetti negativi rilevati, peraltro intrinseci alla tecnica, erano rappresentati dalla mancanza di una visione stereoscopica e dalla impossibilità a procedere ad una palpazione intraoperatoria completa. Questi aspetti che limitano la chirurgia videoassistita rappresentano i punti di forza della chirurgia "open" che a sua volta è però gravata da problematiche come l'invasività e la scarsa tolleranza nei pazienti critici.Le due metodiche possono essere quindi considerate complementari e possono essere proposte in associazione.La chirurgia toracica "open" videoassistita rappresenta pertanto la sintesi ideale dei due approcci, in cui siano apprezzabili i vantaggi di entrambi senza che ne compaiano i relativi svantaggi.I due accessi così concepiti vengono ad avere un valore sinergico che consente di garantire una resa ed un risultato migliore che non utilizzando uno solo dei due.L'intervento eseguito con tecnica "open" videoassistita consente infatti:• Un accesso mininvasivo con incisione chirurgica minima, sensibilmente più contenuta che con la sola tecnica "open", con un risultato migliore dal punto di vista estetico ed un sensibile miglioramento del dolore postoperatorio risultando ridotta la dissezione dei muscoli della parete toracica.• Una visione intraoperatoria magnificata dal supporto video che può rendere possibile l'intervento pur con un'incisione dimensionalmente ridotta.• L'esecuzione del tempo palpatorio con modalità più efficace che con la sola metodica videoendoscopica di palpazione monodigitale (palpazione bidigitale o, in alcuni casi, palpazione manuale).• L'utilizzo di strumentario di chirurgia convenzionale per facilitare l'esecuzione dei tempi chirurgici.• Un'agevole rimozione del pezzo operatorio dal cavo pleurico utilizzando incisioni e tragitti di estrazione differenti (Tab. 1). Questo approccio combinato consente l'esecuzione di interventi anche complessi con le medesime tecniche della chirurgia "open" pur garantendone la mininvasività.L'ottica può essere introdotta attraverso una porta toracoscopica specifica oppure attraverso il miniaccesso "open": in entrambi i casi il risultato appare ottimo in termini di visione e luce intraoperatoria.I campi di impiego sono rappresentati dalla chirurgia polmonare, esofagea, mediastinica, diafram-

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Video-assisted multivessel revascularization through a left anterior small thoracotomy approach with the Symmetry Aortic Connector System

Cited by 10 publications

References 11 publications

Forty-one-month follow-up of the Symmetry aortic connector system for proximal venous anastomosis

Forty-one-month follow-up of the Symmetry aortic connector system for proximal venous anastomosis

Prospective Evaluation of the St. Jude Medical Aortic Connector for Aortic-to-Autologous Vessel Graft Anastomoses

Accessi “Open” Videoassistiti in Chirurgia Toracica

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