850 to 85 yr). Sixty-two patients had three-vessel disease and six patients had two-vessel disease. The mean left ventricular ejec- tion fraction was 53.4±13.2%. All patients underwent CABG through a median sterno- tomy with or without cardiopulmonary bypass using the usual technique. ‘On pump’ surgery was performed in 21 patients and ‘off pump’ in 47 patients. The decision to use the bypass or not was made as each surgeon’s preference. The saphenous vein was harvested and its external diame- ter was assessed in 0.25 mm increments for matching with the most adequate size of the three different connector sys- tems. It was introduced on the transfer sheath and then guid- ed over the release system and was brought over the hooks of the connector with fine-tips forceps. Thus the ACS was load- ed and prepared for deployment. During the loading proce- dure we used He-solution (a mix of verapamil and nitroglyc- erin at pH 7.0) for sufficient soaking (9-11). The aortic wall was punched out using a circular blade and an aortic cutter. The loaded ACS was then inserted into the aorta and the in- ternal struts of the aortic connector were deployed, by push- ing the button on the handle. The anastomosis was accom- plished without side biting of the aorta. The procedure was concluded with a distal anastomosis. Intraoperative blood flows were assessed on all grafts using a Cardiomed Flowme- ter (Medi-Stim, Oslo, Norway) based on the transit time principle. Grafts were evaluated by coronary angiography or multi- slice 16 channel 3-D CT on the 6th postoperative days in all patients and at 6 months postoperatively in 59 patients. All patients received low dose warfarin, aspirin and plavix for 6 months and then the warfarin was discontinued. C.H. Chung, J.W. Lee, J.K. Kang, et al. RESULTS There was no blood leak out of the proximal anastomotic site and no problem was encountered at device release. All patients received a left internal thoracic artery to revascularize the left anterior descending coronary artery, in 30 patients the radial artery was anastomosed as a T graft to the left internal mammary artery. A total of 70 vein grafts were used and all proximal vein graft anastomoses were done with the aortic connector system. Two vein grafts were anastomosed as T grafts to other vein grafts. 49 vein grafts were anastomosed to the posterior descending artery, 5 to a diagonal branch, 13 to an obtuse marginal, 14 to a postero-lateral branch. The mean vein loading time on the connector system was 6.5± 1.0 min. All vein grafts were patent at the end of the proce- dure. Flow measurements were 95.05±2.96 mL/min for single vein grafts. In the immediate postoperative period, no stenosis in the grafted saphenous vein was observed by either angiography (n=22) or 3D CT (n=46). 6 months follow up was done with 59 patients either by angiography (n=7) or by 3-D CT (n= 52). Of these patients, five showed graft stenosis in the mid- portion (Fig. 1, 2) and three in the ostium (Fig. 3). No patients presented with postoperative neurologic com- plications such as stroke, delirium, and an impaired level of consciousness or with a major neuropsychological deficits or operative mortality. No patient was re-explored due to post- operative bleeding, and no complications such as acute renal failure, infection, perioperative myocardial infarction (PMI) occurred. As for the remaining 9 patients, 6 are waiting for their 6-month follow up study and 3 refused additional study due to lack of subjective symptoms. A B Fig. 1. Serial images of 3-D CT at immediate and 6-months postoperatively in 65-yr old man. Note the patent saphenous vein including aortic connector site (A) and the severe stenosis in the midportion of the saphenous vein (arrow) (B). But proximal site is widely patent.