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Ann Thorac Surg. 2017 May;103(5):1489-1497. doi: 10.1016/j.athoracsur.2016.09.024. Epub 2016 Dec 1.

No-Touch Saphenous Vein Harvesting May Improve Further the Patency of Saphenous Vein Composite Grafts: Early Outcomes and 1-Year Angiographic Results.

Author information

1
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea.
2
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea. Electronic address: kimkb@snu.ac.kr.

Abstract

BACKGROUND:

Harvesting technique and surgical strategy may affect patency rates of saphenous vein (SV) grafts in coronary artery bypass graft surgery (CABG). We evaluated early clinical outcomes and 1-year graft patency rates of SV grafts that were harvested with a no-touch technique and used as composite grafts.

METHODS:

Three hundred sixty-eight patients who underwent off-pump CABG using SV composite grafts based on the left internal thoracic artery were studied. The results of 103 patients who received SV grafts harvested with a "no-touch" technique (group NT) were compared with the results of 265 patients who received SV grafts harvested with a "minimal manipulation" technique (group MM). A propensity score-matched analysis was also performed to minimize differences in preoperative and intraoperative variables (n = 98 in each group). Early clinical outcomes and early and 1-year postoperative angiographic results were compared.

RESULTS:

No differences in early mortality or postoperative complications were observed between the two groups. Early postoperative (1.6 ± 2.2 days) angiography demonstrated a significantly higher patency rate of SV grafts in group NT than in group MM before and after propensity score matching (before, 100% versus 97.2%, p = 0.002; after, 100% versus 97.7%, p = 0.003). One-year postoperative (13.0 ± 2.5 months) angiography also showed a higher patency rate of SV grafts in group NT than in group MM before and after propensity score matching (before, 97.4% versus 92.4%, p = 0.024; after, 97.3% versus 92.6%, p = 0.051).

CONCLUSIONS:

The SV grafts harvested with a no-touch technique further improved the early and 1-year patency of SV composite grafts. Midterm and long-term angiographic follow-up may be warranted to demonstrate the superiority of no-touch SV composite grafts.

[Indexed for MEDLINE]

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