Archive | 2021
Five-year patency for the no-touch saphenous vein and the left internal thoracic artery in on- and off-pump coronary artery bypass grafting
Abstract
Background Randomised trials show high long-term patency for no-touch\nsaphenous vein grafts in coronary artery bypass grafting. The patency\nrate in off-pump coronary bypass surgery for these grafts has not been\ninvestigated. Our centre participated in the CORONARY randomized trial,\nNCT00463294. This is a sub-study aimed to assess the patency of no-touch\nsaphenous veins in on- versus off-pump coronary bypass surgery at\nfive-year follow-up. Methods Fifty-six patients were included. Forty of\n49 patients, alive at five years, participated in this follow-up. There\nwere 21 and 19 patients in the on- and off-pump groups respectively.\nNo-touch saphenous veins were used to bypass all targets and in some\ncases the left anterior descending artery. Graft patency according to\ndistal anastomosis was evaluated with computed tomography angiography.\nResults The five-year patency rate was 123/139 (88.5%). The patency for\nthe no-touch vein grafts was 57/64 (89.1%) in the on-pump vs 37/45\n(82.2%) in the off-pump group. All left internal thoracic arteries\nexcept for one, 29/30 (96.6%), were patent. All vein grafts used to\nbypass the left anterior descending and the diagonal arteries were\npatent 32/32. The lowest patency rate for the saphenous veins was to the\nright coronary territory, particularly in off-pump surgery (80.0% vs\n62.5% for the on- respective off-pump groups). Conclusions Comparable\nfive-year patency for the no-touch saphenous veins and the left internal\nthoracic arteries to the left anterior descending territory in both on-\nand off-pump coronary artery bypass grafting. Graft patency in off-pump\nCABG is lower to the right coronary artery.