One-year patency rates of saphenous vein grafts harvested using the no-touch technique in off-pump coronary artery bypass grafting.

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular diagnosis and therapy Pub Date : 2025-02-28 Epub Date: 2025-02-25 DOI:10.21037/cdt-24-295

Ji-Qiang Bu, Jian-Jun Gu, Teng-Yue Zhao, Yu Liu, Guo-Li Zhang, Zi-Ying Chen

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引用次数: 0

Abstract

Background: Coronary artery bypass grafting (CABG) is an effective and durable treatment for coronary artery atherosclerotic heart disease. However, stenosis or occlusion of vein grafts frequently occurs after CABG, posing a significant challenge in postoperative management. This study aims to evaluate the clinical efficacy of saphenous vein graft (SVG) harvesting using the no-touch technique during off-pump CABG (OPCABG).

Methods: In this prospective study, a comparative analysis of 1-year postoperative graft patency rates between left internal mammary artery (LIMA) grafts and SVGs harvested using the no-touch technique was conducted. The recruiting and data collection period was between June 2018 and December 2020. The study included 140 patients who underwent OPCABG at the Heart Center of The Second Hospital of Hebei Medical University. The primary outcomes assessed were the occurrence of major adverse cardiovascular and cerebrovascular events (MACCEs), which encompassed all-cause mortality, sudden cardiac death, acute myocardial infarction, recurrent angina, coronary revascularization, cerebral infarction, and cerebral hemorrhage, as well as the 1-year graft patency rate.

Results: No MACCEs occurred during the perioperative period, and all patients survived to discharge. During follow-up, two patients died, and 10 were lost to follow-up. Of the 128 patients who underwent coronary computed tomography angiography at the 1-year follow-up, there were no statistically significant differences in patency rates between SVGs and LIMA grafts (94.5% vs. 97.7%, P=0.15). Similarly, for end-to-side anastomosis, SVG and LIMA graft patency rates were comparable (93.9% vs. 97.7%, P=0.11). Among these patients, three cases (2.3%) of recurrent angina were reported, predominantly in those with occluded LIMA grafts, while one case of dyspnea was observed in a patient with an occluded SVG.

Conclusions: The 1-year patency rate of SVGs harvested using the no-touch technique was similar to that of LIMA grafts. Further research is warranted to explore the long-term effects of the no-touch technique on SVG patency.

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在体外冠状动脉旁路移植术中采用无接触技术采集的隐静脉移植物的一年通畅率。

背景：冠状动脉旁路移植术（CABG）是治疗冠状动脉粥样硬化性心脏病的有效且持久的方法。然而，冠脉搭桥术后经常发生移植物狭窄或闭塞，给术后处理带来了重大挑战。本研究旨在评价无接触技术在非体外循环CABG （OPCABG）中获取隐静脉移植物（SVG）的临床效果。方法：在这项前瞻性研究中，我们比较分析了左内乳动脉（LIMA）移植物和采用无接触技术采集的svg在术后1年的通畅率。招募和数据收集期为2018年6月至2020年12月。本研究包括在河北医科大学第二医院心脏中心接受OPCABG的140例患者。评估的主要结局是主要心脑血管不良事件（MACCEs）的发生，包括全因死亡率、心源性猝死、急性心肌梗死、复发性心绞痛、冠状动脉血运重建术、脑梗死和脑出血，以及1年移植物通畅率。结果：围手术期无MACCEs发生，全部存活至出院。随访期间，2例死亡，10例失访。在随访1年的128例接受冠状动脉ct血管造影的患者中，svg和LIMA移植的通畅率无统计学差异（94.5% vs 97.7%， P=0.15）。同样，对于端侧吻合，SVG和LIMA移植通畅率相当（93.9% vs 97.7%， P=0.11）。在这些患者中，报告了3例（2.3%）复发性心绞痛，主要发生在LIMA移植物闭塞的患者中，而在SVG闭塞的患者中观察到1例呼吸困难。结论：采用无接触技术获取的svg的1年通畅率与LIMA相似。无接触技术对SVG通畅的长期影响有待进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular diagnosis and therapy Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

4.20%

发文量

期刊介绍： The journal ''Cardiovascular Diagnosis and Therapy'' (Print ISSN: 2223-3652; Online ISSN: 2223-3660) accepts basic and clinical science submissions related to Cardiovascular Medicine and Surgery. The mission of the journal is the rapid exchange of scientific information between clinicians and scientists worldwide. To reach this goal, the journal will focus on novel media, using a web-based, digital format in addition to traditional print-version. This includes on-line submission, review, publication, and distribution. The digital format will also allow submission of extensive supporting visual material, both images and video. The website www.thecdt.org will serve as the central hub and also allow posting of comments and on-line discussion. The web-site of the journal will be linked to a number of international web-sites (e.g. www.dxy.cn), which will significantly expand the distribution of its contents.