Histological aspects of the saphenous vein damage with the use of the Symmetry aortic connector system.

The purpose of the present study was to analyze the histological aspects of the saphenous veins after the use of the Symmetry aortic connector in off pump coronary artery bypass surgery (OPCAB). Nineteen consecutive patients who underwent OPCAB surgery and who received one proximal saphenous vein anastomosis using the St Jude aortic Symmetry connector system were evaluated. In each patient one small segment of the saphenous vein was cut before the use of the Symmetry connector (V0), then another segment after (V1). All segments were stored in an acetone-formaldehyde-alcohol solution before examination. Examination of the V0 segments showed non-specific media fibrosis. In V1, 11 segments presented with a complete alteration of the endothelial layer (58%) and 8 with severe lesions (more than 80%). Among all the V1 segments, 8 had a dissection of the media (42%) and one presented with a wall thrombus. These results suggest that the use of the aortic connector can be associated with different types of lesions of the venous wall. Thus, further investigation and especially long-term follow-up are mandatory to evaluate the consequences of such lesions upon the grafts' patency.