St.Jude Medical Aortic Connector System A A Fig. 2. Immediate postoperative coronary angiogram (A) shows patent graft, whereas diffuse, but very mild narrowing in the mid-portion of graft is observed 6 months later on follow-up image (B). Fig. 3. Severe proximal ostial graft narrowing is observed on 6-month follow-up images of a 75 yr old man (B), which is contrast to Fig. 1, 2 in that other portion of the graft is saved. However it was widely patent at the previous study (A). DISCUSSION Many patients undergoing CABG suffer from periopera- tive cerebrovascular events (1-5%) and neurocognitive dys- function (33-83%) (12, 13). Moreover, it is well known that aortic manipulation and clamping may potentially cause plaque and debris embolization, leading to adverse neuro- logic outcomes. So availability of a sutureless proximal anas- tomotic device is viewed as having the potential to reduce procedural time and the risk of cerebral microemboli during CABG. The symmetry bypass system was developed for the anasto- mosis of vein grafts to the aorta during CABG without mani- pulating the aorta and used in either on- or off-pump proce- dures. It consists of an aortic cutter and an aortic connector for attaching the proximal end of the vein graft to the aorto- 851 B B