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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
Spyder proximal coronary vein graft patency over time: the SPPOT study
Jeffrey M Schussler1, Cory H White, Michael A Fontes
1Department of Internal Medicine, Division of Cardiology, Baylor University Medical Center, Dallas, Texas, USA.
Background:
Clampless proximal anastomoses are associated with fewer strokes in coronary artery bypass (CAB) graft surgery, but lack of patency of proximal grafts has been an issue. The Spyder (Medtronic, Minneapolis, MN, USA) is an "exoconnector" device that deploys a nitinol clamping mechanism to attach a vein onto the aortotomy and create the proximal anastomosis.
Methods:
During a 22-month period we performed gated cardiac computed tomographic angiography on 38 patients who underwent off-pump CAB.
Results:
Of the 49 proximal anastomoses created with the Spyder, 44 (90%) remained patent at the time of study, with a mean follow-up period of 16.7 months.
Conclusions:
The use of the Spyder exoconnector to create a clampless proximal anastomosis during off-pump CAB surgery is a reasonable strategy to improve graft patency.
