Analysis of immediate and mid-term clinical results of great saphenous vein graft harvested by No-touch technique and endoscopic vein harvesting technique

  AIM  To compare the effects of two different great saphenous vein (SVG) harvesting methods (No-touch technique and endoscopic vein harvesting technique) on immediate post-operative clinical results and immediate/mid-term graft patency after coronary artery bypass grafting (CABG).

  METHODS  One hundred and fifty-one patients undergoing CABG surgery in the Department of Cardiovascular Surgery, First Affiliated Hospital of Xi’an Jiaotong University were retrospectively reviewed, including 56 cases of no-touch technique and 95 cases of endoscopic vein harvesting (EVH) technique. All surgeries were approached from median sternotomy with or without the help of cardiopulmonary bypass. The median number of distal anastomoses, the number of left internal thoracic artery (ITA) anastomoses and the number of SVG anastomoses were calculated and compared between the two groups. Early mortality, post-operative complications and leg wound complications such as hematoma and fat liquefaction were also compared between the two groups. Coronary computed tomographic angiography were conducted before discharge and 1 year after surgery to evaluate immediate and mid-term graft patency.

  RESULTS  There were no significant differences in terms of age, gender, risk factors or pre-operative diagnoses. Also there were no significant differences in the number of left ITA anastomoses or number of SVG anastomoses between the two groups. No operative deaths occurred in either group. There were no significant differences in early post-operative complications except in leg wound complications. Leg edema, incision numbness and pain were significantly higher in no-touch group (P<0.05). There were no significant differences in post-operative immediate total graft patency rate, left ITA graft patency rate and SVG graft patency rate. But total graft patency rate during one-year coronary CTA assessment in no-touch group was higher than that in EVH group (P<0.05) and left ITA graft patency rate was the same in both groups. The rate of mild and moderate stenosis was higher in EVH group (P<0.05).

  CONCLUSION  The immediate and mid-term clinical results of SVG graft harvested by no-touch technique in CABG are satisfactory and its mid-term graft patency rate is better than that by EVH technique. No-touch technique is feasible, safe and worthy of wide use for CABG.