J Chest Surg.  2023 Sep;56(5):313-321. 10.5090/jcs.23.027.

Graft Patency of No-Touch Saphenous Veins Used as Aortocoronary Bypass Grafts

• Kim J
• Sohn SH
• Choi JS
• Oh SJ
• Hwang HY

• KMID: 2545976
• DOI: http://doi.org/10.5090/jcs.23.027

Abstract

Background
This study evaluated the early, 1-year, and 3-year graft patency rates and mid-term clinical outcomes after no-touch saphenous veins (NT-SVs) were used as aortocoronary grafts in coronary artery bypass grafting (CABG).
Methods
In total, 101 patients who underwent CABG using NT-SVs as aortocoronary grafts were included. The 2 most common indications for performing aortocoronary grafting with NT-SVs were unavailability of the left internal thoracic artery (n=36) and moderate lesions where flow competition was expected (n=27). Early (median, 1 day; interquartile range [IQR], 1–2 days), 1-year (median, 13 months; IQR, 11–16 months), and 3-year (median, 34 months; IQR, 27–41 months) graft angiography was performed in 98 (97.0%), 84 (83.2%), and 40 patients (39.6%), respectively. The median follow-up duration was 43 months (IQR, 13–76 months). Overall survival rates and the cumulative incidence of major adverse cardiac events were evaluated.
Results
The operative mortality rate was 2% (2 of 101 patients). Early postoperative patency rates for overall and aortocoronary NT-SV grafts were 98.2% (223 of 227 distal anastomoses) and 98.2% (164 of 167), respectively. The 1- and 3-year patency rates for aortocoronary SV grafts were 94.9% (131 of 138) and 90.6% (58 of 64), respectively. The overall survival rates at 5 and 10 years were 81.7% and 59%, respectively. The cumulative incidence of major adverse cardiac events at 5 and 10 postoperative years was 20.7% and 39%, respectively.
Conclusion
The feasibility of using NT-SVs as aortocoronary grafts in CABG was shown in this study, based on the graft patency rates up to 3 years and the mid-term clinical outcomes.

Keyword

Saphenous vein; Coronary artery bypass grafting