Saphenous Vein Tributaries in Sequential Vein Grafting for Coronary Artery Disease

Abstract

Background Sequential vein grafting is utilized to revascularize multiple distal vascular territories in patients with diffusely diseased coronaries undergoing repeat coronary artery bypass grafting (CABG). However, sequential vein grafting is technically challenging due to the side-to-side anastomosis. This study expands on the usage of saphenous vein tributaries in sequential vein grafting (tributary technique) and its outcomes at a single institution. Methods A retrospective observational chart review was conducted on patients who underwent the proposed technique in our institution over three years. The primary outcome variables included all-cause mortality and freedom from major adverse cardiovascular events (MACE). A descriptive analysis was conducted to express the continuous variables as mean and standard deviation and categorical variables as frequency and percentages. Results The study included 187 patients with a mean follow-up duration of 24.8 ± 10.0 months and operative mortality of 1.7%. A total of 131 patients remained symptom-free starting from the date of surgery, and four cardiovascular mortalities were reported during the follow-up period. Conclusion The tributary technique is feasible and can be a potential option in repeat CABGs requiring multiple grafts in patients with adequate vein calibre in lower limbs.