Long Term Patency Evaluation of the Cardica C-Port Distal Anastomotic Device in Coronary Artery Bypass Grafting: Initial Experiencein 91 Grafts.
The Wisconsin Heart Hospital, Milwaukee, WI, USA.
OBJECTIVE:
We have been using the Cardica C-Port distal anastomotic device in coronary bypass grafting since 2006. Early clinical outcomes and graft patency have been favorable. In this retrospective study we sought to evaluate longer term patency in patients receiving the device in our initial experience.
METHODS:
89 patients receiving at least one C-Port device during open coronary artery bypass grafting between February 2006 and August 2007 were contacted and asked retrospectively to participate in a follow up CT angiography (CTA) study for patency evaluation. Forty patients agreed to follow up however 11 were excluded due to elevated creatinine. CTA was obtained in 29 patients at a minimum of 12 months after surgery. Another 14 patients underwent late formal coronary angiography (7 as part of the Pasport trial and 7 for a clinical indication during the same time frame). While these additional patients were not approached for repeat CTA; they were included in the patency analysis. Ninety one grafts constructed with the C-Port device were available for long term follow up in 43 patients and provide the basis of the study.
RESULTS:
The mean length of follow up was 16 + 6 months. Thirty five patients had isolated coronary bypass and eight patients underwent concomitant valve procedures. All of the grafts were constructed off pump. There were four non coronary related deaths in 89 patients. Sixty vein grafts and thirty one internal mammary artery (IMA) grafts were available for patency evaluation. Thirty one of 91 coronary targets (34%) measured 1.5 mm or less. Three generations of C-Port devices were used as follows: (18 C-Port 1, 38 C-Port xA, and 35 C-Port Flex A). Mean intraoperative flow (Transit Time Flowmetry) was 56 cc/min. Thirty of 31 IMA grafts (97%) and 49 of 60 saphenous vein grafts (82%) were patent on follow up.
CONCLUSIONS: This study demonstrates excellent longer term patency during an initial experience with the Cardica C-Port distal anastomotic device in off pump coronary bypass surgery. We continue to use later generations of the device in most open and closed chest coronary bypass procedures. Further follow up is warranted.
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