Equivalent 10-year angiographic and long-term clinical outcomes with saphenous vein composite grafts and arterial composite grafts

Commentary: Composite grafting with the saphenous vein—Y not?

“…Finally, we do not know the generalizability of the SV conduit management steps (no-touch pedicle vein harvest with valvulotomy), nor do we know the role of these steps in the intriguing results of Hwang and colleagues. 1 Despite the study's limitations, the counterintuitive concept presented by Hwang and colleagues 1 is important. The SV is still the most widely used conduit after the LITA, even though the literature suggests that SV long-term patency is limited relative to arterial grafts.…”

Commentary: Right gastroepiploic artery versus right internal thoracic artery: Backing the wrong horse

“…The same questions apply to this group's other recent paper. 15 Finally, and back to the current study, is it justified to perform a laparotomy and open the peritoneum to harvest the RGEA, when it's becoming clear, by accumulating studies, that the skeletonized harvest technique of the RITA lowers the risk of sternal wound infection similar to 1 pedicled LITA? 16 Indeed, in the current report, there was no apparent increase in sternal infection rate with the additional skeletonized harvest of the RITA.…”

Reopening of the Occluded Saphenous Vein Composite Grafts After Coronary Artery Bypass Grafting

“…When we compared group R with group O, there were no differences in demographic data and preoperative risk factors between the 2 groups (Table 1). The median number of distal anastomoses per patient was 4.0 [3,4] and the median number of distal anastomoses per SV conduit was 3.0 [2.0, 3.8]. The percentage of SV harvested with pedicle tissue was higher in group R than in group O, with marginal significance (64.3% [9/14] versus 31.2% [10/32]; P =0.077).…”

“…The saphenous vein (SV) is still the most commonly used secondary conduit for myocardial revascularization even though it has disadvantages of declining patency with time and resultant worse clinical outcomes compared with patency and outcomes of the internal thoracic artery (ITA) conduit [1]. Of numerous efforts to overcome the structural and functional limitations of SV conduit, the "no-touch" SV (NT SV) harvesting technique with or without a surrounding pedicle tissue and the surgical strategy of using the NT SV as part of a composite graft based on the left ITA have demonstrated good SV conduit patency rates comparable to arterial conduit patency rates [2][3][4]. Another recent study from our group demonstrated that NT SV conduits harvested with pedicle tissue further improved the early and 1-year patency of SV composite grafts, compared with NT SV conduits harvested without pedicle tissue [5].…”