Spyder proximal coronary vein graft patency over time: the SPPOT study.

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.