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
saphenous vein grafts in coronary artery bypass grafting. The patency
rate in off-pump coronary bypass surgery for these grafts has not been
investigated. Our centre participated in the CORONARY randomized trial,
NCT00463294. This is a sub-study aimed to assess the patency of no-touch
saphenous veins in on- versus off-pump coronary bypass surgery at
five-year follow-up. Methods Fifty-six patients were included. Forty of
49 patients, alive at five years, participated in this follow-up. There
were 21 and 19 patients in the on- and off-pump groups respectively.
No-touch saphenous veins were used to bypass all targets and in some
cases the left anterior descending artery. Graft patency according to
distal anastomosis was evaluated with computed tomography angiography.
Results The five-year patency rate was 123/139 (88.5%). The patency for
the no-touch vein grafts was 57/64 (89.1%) in the on-pump vs 37/45
(82.2%) in the off-pump group. All left internal thoracic arteries
except for one, 29/30 (96.6%), were patent. All vein grafts used to
bypass the left anterior descending and the diagonal arteries were
patent 32/32. The lowest patency rate for the saphenous veins was to the
right coronary territory, particularly in off-pump surgery (80.0% vs
62.5% for the on- respective off-pump groups). Conclusions Comparable
five-year patency for the no-touch saphenous veins and the left internal
thoracic arteries to the left anterior descending territory in both on-
and off-pump coronary artery bypass grafting. Graft patency in off-pump
CABG is lower to the right coronary artery.