No-Touch Saphenous Vein Harvesting May Improve Further the Patency of Saphenous Vein Composite Grafts: Early Outcomes and 1-Year Angiographic Results

Background. Harvesting technique and surgical strategy may affect patency rates of saphenous vein (SV) grafts in coronary artery bypass graft surgery (CABG). We evaluated early clinical outcomes and 1-year graft patency rates of SV grafts that were harvested with a no-touch technique and used as composite grafts. Methods. Three hundred sixty-eight patients who underwent off-pump CABG using SV composite grafts based on the left internal thoracic artery were studied. The results of 103 patients who received SV grafts harvested with a "no-touch" technique (group NT) were compared with the results of 265 patients who received SV grafts harvested with a "minimal manipulation" technique (group MM). A propensity score-matched analysis was also performed to minimize differences in preoperative and intraoperative variables (n = 98 in each group). Early clinical outcomes and early and 1-year postoperative angiographic results were compared. Results. No differences in early mortality or postoperative complications were observed between the two groups. Early postoperative (1.6 +/- 2.2 days) angiography demonstrated a significantly higher patency rate of SV grafts in group NT than in group MM before and after propensity score matching (before, 100% versus 97.2%, p = 0.002; after, 100% versus 97.7%, p = 0.003). One-year postoperative (13.0 +/- 2.5 months) angiography also showed a higher patency rate of SV grafts in group NT than in group MM before and after propensity score matching (before, 97.4% versus 92.4%, p = 0.024; after, 97.3% versus 92.6%, p = 0.051). Conclusions. The SV grafts harvested with a no-touch technique further improved the early and 1-year patency of SV composite grafts. Midterm and long-term angiographic follow-up may be warranted to demonstrate the superiority of no-touch SV composite grafts. (C) 2017 by The Society of Thoracic Surgeons