Long-term clinical outcomes after coronary artery bypass grafting with pedicled saphenous vein grafts

Janiec, Mikael; Friberg, Örjan; Thelin, Stefan

doi:10.1186/s13019-018-0800-z

Cited by 21 publications

(10 citation statements)

References 22 publications

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“…Previous studies showed that the vein grafts obtained by NT technology were mostly single vein grafts, and the most common surgery was on-pump CABG. 9,12,14,15 This is different from our study;…”

Section: Discussioncontrasting

confidence: 99%

The expansion of no‐touch harvesting sequential vein graft after off‐pump coronary artery bypass grafting

Hou

Zhang

Liu

et al. 2021

Journal of Cardiac Surgery

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Background and Aim of the Study: Many studies support that the no-touch (NT) procedure can improve the patency rate of vein grafts. However, it is not clear that the sequential vein graft early expansion in the NT technique during off-pump coronary artery bypass grafting (CABG). This study will explore this issue.Methods: This was a prospective single-center randomized controlled clinical trial. A total of 100 patients undergoing off-pump CABG with the sequential saphenous graft were randomly assigned to two groups: the NT and conventional (CON) groups. Perioperative and postoperative data were collected during the hospital stay. The mean diameter of sequential grafts was measured using cardiac computed tomography angiography 3 months after the operation.Results: There was a significant difference in the average diameter of sequential grafts between the two groups (NT: [2.98 ± 0.42], CON: [3.26 ± 0.51], p = .005). There was no difference in occlusion of sequential venous grafts between the two groups (NT: 4/48 [8.3%], CON: 5/49 [10.2%], p = 1.000). There were differences in surgery time between the two groups (NT: 220 [188,240], CON: 190 [175,230], p = .009). Conclusions:The sequential graft early expansion in the NT technique is not as pronounced as that in the conventional technique, which may have a long-term protective effect on the grafts.cardiac computed tomography angiography (CCTA), conventional saphenous vein graft harvesting, coronary artery bypass grafting (CABG), no-touch saphenous vein graft harvesting, off-pump CABG, sequential saphenous vein graftingThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Discussioncontrasting

confidence: 99%

The expansion of no‐touch harvesting sequential vein graft after off‐pump coronary artery bypass grafting

Hou

Zhang

Liu

et al. 2021

Journal of Cardiac Surgery

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show abstract

“…Previous studies showed that the vein grafts obtained by NT technology were mostly single vein grafts, and the most common surgery was on-pump CABG [7,9,20,21]. This is different from our study; we used all sequential vein grafts, and all procedures were off-pump CABG.…”

Section: Discussionmentioning

confidence: 57%

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

Hou

Zhang

Liu

et al. 2021

Preprint

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Background 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 technique (NT) were higher than those obtained by the conventional technique (CON). In the past, NT technology was mainly used in on-pump coronary artery bypass grafting (CABG), and vein grafts were mostly single vein grafts. In this study, we retrospectively analysed the safety and effectiveness of sequential vein grafts using NT technology in off-pump CABG. Methods From 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, postoperative complications, leg wound complications and 1-year major adverse cardiac and cerebrovascular events (MACCEs) were compared between the two groups. Results There was no significant difference in the patency rate of sequential venous grafts between the two groups one 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). Conclusions The application of the NT technique in off-pump CABG with sequential vein grafts is safe and effective. Leg wound complications are more common with the NT technique than with the conventional technique.

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“…Current literature supports that handling during harvesting has an impact on the quality of the vein grafts if it is harvested by an inexperienced practitioner 2,8 . However, there are other factors which also have strong influence on the success of these vein grafts, including target vessels, progressive native artery atherosclerosis, patient co-morbidities, experience of the surgeon grafting and patient lifestyle 9,10 . Currently, there are no studies with long term follow-up of patients with comparison of outcomes between EVH and OVH in the United Kingdom (UK).…”

Section: Introductionmentioning

confidence: 99%

A multicentre review comparing long term outcomes of endoscopic vein harvesting versus open vein harvesting for coronary artery bypass surgery

et al. 2021

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Background: Utilisation of the Endoscopic Vein Harvesting (EVH) technique has been increasing for coronary artery bypass grafting (CABG) for the last two decades. Some surgeons remain concerned about the long-term patency of the long saphenous vein harvested endoscopically compared to traditional Open Vein Harvesting (OVH). The aim of this study was to perform a retrospective analysis of the outcomes between EVH and OVH from three UK centres with 10 years follow-up. Methods: 27,024 patients underwent CABG with long saphenous vein harvested by EVH (n=13,794) or OVH (n=13,230) in three UK centres between 2007 and 2019. Propensity modelling was used to calculate the Inverse Probability of Treatment Weights (IPTW). The primary endpoint was mortality from all causes and secondary endpoints were length of hospital stay, postoperative complications, and incidence of repeat coronary re-vascularisation for symptomatic patients. IPTW was used to balance the two intervention groups for baseline and preoperative co-morbidities. Results: Median follow-up time was 4.54 years for EVH and 6.00 years for OVH. Death from any cause occurred in 13.8% of the EVH group versus 20.8% in the OVH group over the follow-up period. The hazard ratio of death (EVH to OVH) was 0.823 (95% CI: 0.767, 0.884). Length of hospital stay was similar between the groups (p=0.86). Post-operative pulmonary complications were more common in EVH vs OVH (14.7% vs. 12.8%, p<0.001), but repeat coronary re-vascularisation was similar between the groups. Conclusion: This large retrospective multicentre analysis indicates that EVH has a lower risk of mortality compared with OVH during the follow-up period of the study. The observed benefits of EVH may outweigh the risks but should be considered on a case-by-case basis. We hope this review gives confidence to other cardiac centres that offering an EVH approach to conduit harvesting does not affect long term patient outcomes.

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Long-term clinical outcomes after coronary artery bypass grafting with pedicled saphenous vein grafts

Cited by 21 publications

References 22 publications

The expansion of no‐touch harvesting sequential vein graft after off‐pump coronary artery bypass grafting

The expansion of no‐touch harvesting sequential vein graft after off‐pump coronary artery bypass grafting

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

A multicentre review comparing long term outcomes of endoscopic vein harvesting versus open vein harvesting for coronary artery bypass surgery

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