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The Symmetry proximal connector device was introduced as a facilitator for construction of proximal anastomosis in coronary bypass surgery. Use of the connector made it unnecessary to clamp the ascending aorta. Early results were promising, but a controlled study performed in our center demonstrated poor angiographic patency of saphenous veins attached with the connector. The objective of this study was to investigate long-term clinical results in patients operated with connector or traditional suture technique.At a minimum of 5 years after surgery, medical records of 46 patients who had undergone off-pump coronary bypass with Symmetry (n = 23) or traditional suture (n = 23) were examined, and the patients were interviewed personally by phone. Patients were asked about the presence of angina pectoris, hospital admission for cardiac conditions, or the need for new interventions. The Norwegian population registry was used to document survival status.Two control patients and five Symmetry patients died during the observation period (P = 0.414). Seven Symmetry and one control patient required reintervention (P = 0.015). Of the patients who were interviewed, 8 of 19 Symmetry patients suffered from angina and none of 20 control patients (P = 0.003).Patients who were operated with the Symmetry connector device have a high chance of having cardiac ischemia in the intermediate to long term after surgery, despite of relatively frequent reintervention. Patients operated with this connector requires close clinical follow-up.