Mats Dreifaldt1, John D Mannion2, Håkan Geijer3, Mats Lidén3, Lennart Bodin4, Domingos Souza5. 1. Faculty of Medicine and Health, Department of Cardiothoracic and Vascular Surgery and University Health Care Research Center, Örebro University, Örebro, Sweden. 2. Department of Surgery, Bayhealth Medical Center, Dover, Del. 3. Faculty of Medicine and Health, Department of Radiology, Örebro University, Örebro, Sweden. 4. Unit of Intervention and Implementation Research, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden. 5. Faculty of Medicine and Health, Department of Cardiothoracic and Vascular Surgery and University Health Care Research Center, Örebro University, Örebro, Sweden. Electronic address: domingos.ramosdesouza@regionorebrolan.se.
Abstract
BACKGROUND: In 2004, a prospective randomized trial demonstrated that after 3 years, saphenous veins (SVs) harvested with a no touch (NT) technique had a greater patency than radial grafts for coronary bypass surgery. Here we report the 8-year follow-up data of this trial. METHODS: The trial included 108 patients undergoingcoronary artery bypass grafting (CABG). Each patient was assigned to receive 1 NT SV and 1 radial artery (RA) graft to either the left or right coronary territory to complement the left internal thoracic artery (LITA). Sequential grafting was common, so overall graft patency as well as the patency of each anastomosis were assessed. RESULTS: Angiography was performed in 84 patients (78%) at mean of 97 months postoperatively. Graft patency were high and similar for both NT and RA: 86% for NT versus 79% for RA (P = .22). The patency of coronary anastomoses was significantly higher with the NT SV grafts (91% vs 81%; P = .046). The NT grafts also had excellent patency in coronary arteries with <90% stenosis (93% patency) and in coronary arteries of small diameter (87% patency) or with mild calcification (88% patency). Patency for the LITA was 92%. CONCLUSIONS:NT SV grafts have excellent patency similar to that of RA grafts after 8 years. In addition, NT SV grafts can be used in situations that are not ideal for RA grafts.
RCT Entities:
BACKGROUND: In 2004, a prospective randomized trial demonstrated that after 3 years, saphenous veins (SVs) harvested with a no touch (NT) technique had a greater patency than radial grafts for coronary bypass surgery. Here we report the 8-year follow-up data of this trial. METHODS: The trial included 108 patients undergoing coronary artery bypass grafting (CABG). Each patient was assigned to receive 1 NT SV and 1 radial artery (RA) graft to either the left or right coronary territory to complement the left internal thoracic artery (LITA). Sequential grafting was common, so overall graft patency as well as the patency of each anastomosis were assessed. RESULTS: Angiography was performed in 84 patients (78%) at mean of 97 months postoperatively. Graft patency were high and similar for both NT and RA: 86% for NT versus 79% for RA (P = .22). The patency of coronary anastomoses was significantly higher with the NT SV grafts (91% vs 81%; P = .046). The NT grafts also had excellent patency in coronary arteries with <90% stenosis (93% patency) and in coronary arteries of small diameter (87% patency) or with mild calcification (88% patency). Patency for the LITA was 92%. CONCLUSIONS:NT SV grafts have excellent patency similar to that of RA grafts after 8 years. In addition, NT SV grafts can be used in situations that are not ideal for RA grafts.
Authors: Mario Gaudino; Irbaz Hameed; N Bryce Robinson; Yongle Ruan; Mohamed Rahouma; Ajita Naik; Viola Weidenmann; Michelle Demetres; Derrick Y Tam; David L Hare; Leonard N Girardi; Giuseppe Biondi-Zoccai; Stephen E Fremes Journal: J Am Heart Assoc Date: 2021-03-09 Impact factor: 5.501
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