Introduction
The saphenous vein (SV)continues to be a very important conduit in
coronary artery bypass grafting (CABG) 1. Therefore,
every effort should be made to improve the short and long-term patency
of SV grafts (SVGs). The no-touch (NT) SVG harvesting technique was
introduced in the 1990s. The NT SVG is harvested together with its fat
pedicle preventing spasm and the need for manual dilatation2. A randomized study comparing the NT to the
conventional vein harvesting technique, showed significantly higher
patency for NT SVGs comparable to that of the left internal thoracic
artery (LITA) 16 years postoperatively 3-5. Coronary
artery bypass grafting is commonly performed with the support of
cardiopulmonary bypass (CPB), so called on-pump procedure. Perioperative
mortality is about 2% and the rate of myocardial infarction, stroke or
renal failure requiring dialysis is 5-7% 6. The
technique of performing CABG without CPB, off-pump surgery, was
developed to reduce these perioperative complications7.
The CABG Off or On-pump Revascularization study (CORONARY trial,
NCT00463294) is a large international multicenter randomized controlled
trial. It was designed to overcome some of the limitations of prior
trials 8. Our department was one of the including
centers. The 30-days, one year and five-year results have been published6, 9. Graft patency was not evaluated in this study
despite being a major determinant of clinical prognosis, measured by
reoperation rates and long-term survival 10.Therefore,
the aim of this sub-study is to assess graft patency in on- vs off-pump
CABG in the cohort of patients operated at our department, especially
considering that all vein grafts were harvested with the NT technique.
Graft patency according to the different target coronary arteries was
also studied.