Morphological Evaluation of Proximal Anastomosis by PAS-Port ® System in Patients with Long-Term Patent Grafts

Purpose: We examined grafts employing for morphological analysis of early and long-term results on proximal anastomosis with the PAS-Port®. Methods: One hundred and four patients treated by OPCAB with PAS-Port® were performed postoperative MDCT. Morphological evaluation of the proximal anastomotic region was classified into three groups (A; graft was anastomosed almost perpendicularly to the aortic wall, B; graft was same type A, but subsequently curved to form an acute angle with the aortic wall, C; graft take off acute angle with the aortic wall) evaluated on planar and sagittal sections. Results: One hundred twenty-six PAS-Port® were used. Patency rate was 99.0% at discharge, 94.7% at 1 year, and no blockages were detected thereafter in patients examined. The morphology rate was A 50.6%, B 15.3% and C 34.1% on planar sections, and A 58.8%, B 10.6% and C 30.6% on sagittal sections. Conclusion: The morphological evaluation of grafts revealed the degree of freedom in graft design to be relatively high and long-term patency posed no particular problem even if the layout of the proximal anastomotic region involved a relatively acute angle. The PAS-Port® was considered to be a highly reliable device which performed appropriate proximal anastomosis and improved the patency of vein grafting to the aortic wall.