No-Touch Sequential Saphenous Venous Harvesting Technique in Off-Pump Bypass Surgery: A Retrospective Study.

Xuejian Hou,Kui Zhang,Jubing Zheng,Bangrong Song,Zhuhui Huang,Taoshuai Liu,Yang Zhao,Yang Li,Ran Dong

doi:10.3389/fcvm.2021.804739

Xuejian Hou, Kui Zhang + Show 7 more

Open Access

https://doi.org/10.3389/fcvm.2021.804739

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Abstract

BackgroundIn the mid-1990s, the Swedish expert team proposed saphenous vein graft (SVG) harvesting with pedicle tissue. The short-term and long-term patency rates of the great saphenous vein obtained by the no-touch (NT) were higher than those obtained by the conventional (CON). In the past, NT harvesting was mainly used in on-pump coronary artery bypass grafting (CABG), and vein grafts were mostly single vein grafts. In this study, we retrospectively analyzed the safety and effectiveness of sequential vein grafts using NT harvesting in off-pump CABG.MethodsFrom 2017 to 2019, a total of 505 patients were included in the study. There were 150 patients in the NT group and 355 patients in the CON group. After applying propensity score matching (1:1 matching), 148 patients were included in each group. Baseline data, graft patency, post-operative complications, leg wound complications and 1-year major adverse cardiac and cerebrovascular events (MACCEs) were compared between the two groups.ResultsThere was no significant difference in the patency rate of sequential venous grafts between the two groups 1 year after the operation either before [NT: 7.1% (10/141) vs. CON: 11.5% (38/331), p = 0.149) or after matching (NT: 7.1% (10/140) vs. CON: 7.3% (9/124), p = 0.971]. There was no significant difference in the composite clinical endpoint between the two groups either before [NT: 3 (2.3%) vs. CON: 9 (2.8%), p = 1.000] or after matching [NT: 3 (2.3%) vs. CON: 3 (2.5%), p = 1.000]. There were differences in leg wound complications between the two groups both before [NT: 9 (6.9%) vs. CON: 6 (1.9%), p = 0.007] and after matching [NT: 9 (6.9%) vs. CON: 2 (1.7%), p = 0.043].ConclusionsThe application of the NT harvesting in off-pump CABG with sequential vein grafts is safe and effective. NT method has disadvantages in leg wound.

Highlights

Coronary artery disease is a serious threat to human health, especially complex coronary artery disease
coronary artery bypass grafting (CABG) is a good remedy for coronary artery diseases that are difficult to manage with interventional treatment
The pedicled SV grafts are probably more durable than skeletonized venous segments. They conducted a shortterm and long-term follow-up study that showed that the shortterm and long-term patency rates of the great saphenous vein obtained by NT harvesting were higher than those obtained by the conventional procedure, especially in the long-term followup [8, 9]

Summary

Introduction

Coronary artery disease is a serious threat to human health, especially complex coronary artery disease. The pedicled SV grafts are probably more durable than skeletonized (conventional) venous segments. They conducted a shortterm and long-term follow-up study that showed that the shortterm and long-term patency rates of the great saphenous vein obtained by NT harvesting were higher than those obtained by the conventional procedure, especially in the long-term followup [8, 9]. In the mid-1990s, the Swedish expert team proposed saphenous vein graft (SVG) harvesting with pedicle tissue. The short-term and long-term patency rates of the great saphenous vein obtained by the no-touch (NT) were higher than those obtained by the conventional (CON).

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Conclusion