AUTHOR=Hou Xuejian , Zhang Kui , Liu Taoshuai , Li Yang , Zhao Yang , Song Bangrong , Huang Zhuhui , Zheng Jubing , Dong Ran 

TITLE=No-Touch Sequential Saphenous Venous Harvesting Technique in Off-Pump Bypass Surgery: A Retrospective Study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.804739

DOI=10.3389/fcvm.2021.804739

ISSN=2297-055X

ABSTRACT=Background: In the mid-1990s, the Swedish expert team proposed saphenous vein graft (SVG) harvesting with pedicle tissue. The short-term and long-term patency rates of the great saphenous vein obtained by the no-touch technique (NT) were higher than those obtained by the conventional technique (CON). In the past, NT technology was mainly used in on-pump coronary artery bypass grafting (CABG), and vein grafts were mostly single vein grafts. In this study, we retrospectively analysed the safety and effectiveness of sequential vein grafts using NT technology in off-pump CABG.
Methods: From 2017 to 2019, a total of 505 patients were included in the study. There were 150 patients in the NT group and 355 patients in the CON group. After applying propensity score matching (1:1 matching), 148 patients were included in each group. Baseline data, graft patency, postoperative complications, leg wound complications and 1-year major adverse cardiac and cerebrovascular events (MACCEs) were compared between the two groups.
Results: There was no significant difference in the patency rate of sequential venous grafts between the two groups one year after the operation either before (NT: 7.1% (10/141) vs CON: 11.5% (38/331), p= 0.149) or after matching (NT: 7.1% (10/140) vs CON: 7.3% (9/124), p=0.971). There was no significant difference in the composite clinical endpoint between the two groups either before (NT: 3 (2.3%) vs CON: 9 (2.8%), p=1.000) or after matching (NT: 3 (2.3%) vs CON: 3 (2.5%), p=1.000). There were differences in leg wound complications between the two groups both before (NT: 9 (6.9%) vs CON: 6 (1.9%), p=0.007) and after matching (NT: 9 (6.9%) vs CON: 2 (1.7%), p=0.043).
Conclusions: The application of the NT technique in off-pump CABG with sequential vein grafts is safe and effective. Leg wound complications are more common with the NT technique than with the conventional technique.