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

Abstract

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-yeargraft patency rates of SV grafts that were harvestedwith a no-touch technique and used as composite grafts. 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 inpreoperative and intraoperative variables (n= 98 ineach group). Early clinical outcomes and early and1-year postoperative angiographic results were compared. 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). 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.