Abstract
The saphenous vein is the most common conduit used in coronary artery bypass grafting (CABG) yet its failure rate is higher compared to arterial grafts. An improvement in saphenous vein graft performance is therefore a major priority in CABG. No-touch harvesting of the saphenous vein is one of the few interventions that has shown improved patency rates, comparable to that of the left internal thoracic artery. After more than two decades of no-touch research, this technique is now recognized as a Class IIa recommendation in the 2018 European Society of Cardiology and the European Association for Cardio-Thoracic Surgery guidelines on myocardial revascularization. In this review, we describe the structural alterations that occur in conventional versus no-touch saphenous vein grafts and how these changes affect graft patency. In addition, we discuss various strategies aimed at repairing saphenous vein grafts prepared at conventional CABG.
Highlights
The saphenous vein is the most common conduit used in coronary artery bypass grafting (CABG) yet its failure rate is higher compared to arterial grafts
We describe the structural alterations that occur in conventional versus no-touch saphenous vein grafts and how these changes affect graft patency
In a recent History of Medicine Perspective published in the New England Journal of Medicine, Jones DS[1] outlines the important contribution to coronary artery bypass grafting (CABG) made by Rene Favaloro, who first introduced the saphenous vein (SV) as a conduit for coronary revascularization[2]
Summary
Twenty-Five Years of No-Touch Saphenous Vein Harvesting for Coronary Artery Bypass Grafting: Structural Observations and Impact on Graft Performance. Ninos Samano, MD, PhD; Domingos Souza, MD, PhD; Bruno Botelho Pinheiro, MD, MSc; Tomislav Kopjar, MD, PhD; Michael Dashwood, PhD
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