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

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.