Prospective, Randomized Study on the Use of the Cardica PAS-Port Aortic Connector System in Off-Pump Coronary Artery Bypass Surgery


  • Jarmo Lahtinen
  • Fausto Biancari
  • Risto Ojala
  • Martti Mosorin
  • Riccardo Cresti
  • Pekka Rainio
  • Vesa Anttila
  • Martti Lepojärvi
  • Tatu Juvonen



Background. The use of aortic connector devices for proximal vein graft anastomosis has been shown to be associated with a relevant rate of early graft complications. Cardica PAS-Port is a new aortic connector whose preliminary clinical results seem promising. The safety and efficacy of this aortic connector device have been evaluated in this prospective, randomized study.

Material and Methods. Twenty-four patients were randomized to receive proximal aorta-vein graft anastomosis with either the Cardica PAS-port aortic connector or by the hand-sewn technique. Twenty-three patients underwent multidetector computed tomographic scan (MDCT) of the chest 6 months after surgery to evaluate graft patency.

Results. All aortic connector devices (18) were successfully deployed and 31 proximal anastomoses were performed by the hand-sewn technique. MDCT showed that 6-month freedom from vein graft complication was 22.2% in the PAS-Port group and 58.1% in the hand-sewn group (P = .04). Four vein grafts (22.2%) anastomosed with the PAS-Port and 2 hand-sewn vein grafts (6.5%) were occluded (P = .10). The use of the PAS-Port aortic connector was also predictive of any vein graft complication when adjusted for vein graft flow (P = .01; OR 8.64, 95% CI 1.66-45.00) and for peripheral resistance units (P = .02; OR 6.14, 95% CI 1.33-28.43).

Conclusions. The results of this prematurely stopped, prospective, randomized study suggest that the use of PAS-Port aortic connector device is associated with a higher rate of early vein graft complications than the hand-sewn technique.


Bergsland J, Hol PK, Lingås PS, et al. 2004. Intraoperative and intermediate-term angiographic results of coronary artery bypass surgery with Symmetry proximal anastomotic device. J Thorac Cardiovasc Surg 128:718-23.nCavendish JJ, Penny WF, Madani MM, et al. 2004. Severe ostial saphenous vein graft disease leading to acute coronary syndromes following proximal aorto-saphenous anastomoses with the Symmetry bypass connector device. J Am Coll Cardiol 43:133-9.nChiurlia E, Menozzi M, Ratti C, Romagnoli R, Modena MG. 2005. Follow up of coronary artery bypass graft patency by multislice computed tomography. Am J Cardiol 95:1094-7.nGummert JF, Opfermann U, Kempfert J, et al. 2005. A single center comparison of proximal anastomoses performed with the PAS-Port device versus hand sewn technique--results from a prospective randomized study [abstract]. International Society for Minimally Invasive Cardiothoracic Surgery, 2005 Annual Scientific Meeting, 156-7.nHarringer W, Demertzis S, Treede H, et al. 2005. Six month angiographic and two year clinical follow-up from the Cardica PAS-Port pivotal trial [abstract]. International Society for Minimally Invasive Cardiothoracic Surgery, 2005 Annual Scientific Meeting, 158-9.nBurgstahler C, Kuettner A, Kopp AF, et al. 2003. Non-invasive evaluation of coronary artery bypass grafts using multi-slice computed tomography: initial clinical experience. Int J Cardiol 90:275-80.nLahtinen J, Biancari F, Mosorin M, et al. 2004. Fatal complications after use of the Symmetry aortic connector in coronary artery bypass surgery. Ann Thorac Surg 77:1817-9.nSong MH, Ito T, Watanabe T, Nakamura H. 2005. Multidetector computed tomography versus coronary angiogram in evaluation of coronary artery bypass grafts. Ann Thorac Surg 79:585-8.nMaisel WH. 2005. A device for proximal anastomosis of autologous coronary vein grafts: report from the meeting of the Circulatory System Devices Panel of the Food and Drug Administration Center for Devices and Radiologic Health. Circulation 112:1516-8.nMelero JM, Porras C, Such M, Olalla E, Alonso J. 2004. Severe stenosis of anastomoses by using the Symmetry aortic connector system. Ann Thorac Surg 78:1831-3.nMoore RKG, Sampson C, MacDonald S, Moynahan C, Groves D, Chester MR. 2005. Coronary artery bypass graft imaging using ECG-gated multislice computed tomography: comparison with catheter angiography. Clin Radiol 60:990-8.nSalm LP, Bax JJ, Jukema W, et al. 2005. Comprehensive assessment of patients after coronary artery bypass grafting by 16-detector row computed tomography. Am Heart J 150:775-81.nSchlosser T, Konorza T, Hunold P, Kühl H, Schmermund A, Barkhausen J. 2004. Noninvasive visualization of coronary artery bypass grafts using 16-detector row computed tomography. J Am Coll Cardiol 44:1224-9.nTraverse JH, Mooney MR, Pedersen WR, et al. 2003. Clinical, angiographic, and interventional follow-up of patients with aortic-saphenous vein graft connectors. Circulation 108:452-6.nMartens S, Dietrich M, Herzog C, et al. 2004. Automatic connector devices for proximal anastomoses do not decrease embolic debris compared with conventional anastomoses in CABG. Eur J Cardiothorac Surg 25:993-1000.n



How to Cite

Lahtinen, J., Biancari, F., Ojala, R., Mosorin, M., Cresti, R., Rainio, P., Anttila, V., Lepojärvi, M., & Juvonen, T. (2006). Prospective, Randomized Study on the Use of the Cardica PAS-Port Aortic Connector System in Off-Pump Coronary Artery Bypass Surgery. The Heart Surgery Forum, 9(2), E568-E571.




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