1. Is the GraftConnector a valid alternative to running suture in end-to-side coronary arteries anastomoses? 
Piergiorgio Tozzi, MD, Jan Otto Solem, MD, D Boumzebra, MD, Antonio Mucciolo, Claude Y Genton, MD, Pascal Chaubert, MD, Ludwig Karl von Segesser, MD 
The Annals of Thoracic Surgery 
Volume 72, Issue 3, Pages S999-S1003 (September 2001)
DOI: /S (01)

2. Fig 1
1. The conduit (internal mammary artery) is connected inside the sidearm of the GraftConnector (GC) before conducting the anastomosis. The sleeve being inserted into the artery is in the crimped position. 2. An arteriotomy is made and the tip of the GC is inserted into the coronary artery. 3. The main body of the GC is positioned in the coronary artery. 4. By pulling the cap 3-mm out, the expansion of the main body is activated. The anastomosis is now completed and the handle is retrieved.
The Annals of Thoracic Surgery  , S999-S1003DOI: ( /S (01) )

3. Fig 2
Representation of fluoroscopic images of end-to-side anastomosis done with the GraftConnector between right internal mammalian artery (RIMA) and left anterior descending artery (LAD). a = RIMA’s maximal diameter; b = smallest GraftConnector’s diameter; c = distal LAD’s maximal diameter (usually 1 cm distal to the end of GraftConnector). The large arrow shows the junction between the device and the native vessel (transition area). Dashed lines represent histologic section plans.
The Annals of Thoracic Surgery  , S999-S1003DOI: ( /S (01) )

4. Fig 3
Postoperative fluoroscopy control of the coronary artery bypass grafting performed with the GraftConnector. RIMA = right internal mammary artery; LAD = left anterior descending coronary artery; a, b, and c represent the sites where measurements were taken with Image-Pro Plus 4 in order to calculate anastomotic diameter compared with distal LAD.
The Annals of Thoracic Surgery  , S999-S1003DOI: ( /S (01) )

5. Fig 4
Cross-section of left anterior descending coronary artery (LAD) at the anastomotic site. The anastomosis was carried out with the GraftConnector. The yellow outline shows the device cross-sectional area, which is considered as the reference area, assuming that this was the native artery cross-sectional area at the implantation (hypothetical native LAD cross-sectional area that corresponds to real native LAD cross-sectional area only if the GraftConnector is correctly sized). The green outline shows the luminal width after 6 months.
The Annals of Thoracic Surgery  , S999-S1003DOI: ( /S (01) )

6. Fig 5
Specimen has been cut axially to better identify the transition area (Fig 2). The GraftConnector is oversized compared with the left anterior descending coronary artery and the difference between the two diameters has been filled out with intima (green arrow).
The Annals of Thoracic Surgery  , S999-S1003DOI: ( /S (01) )