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. 2022 Jul 12:15:87-94.
doi: 10.1016/j.xjtc.2022.07.005. eCollection 2022 Oct.

Impact of the no-touch harvesting technique on the vessel diameter of saphenous vein grafts for coronary artery bypass grafting

Hiroshi Kurazumi  1 , Ryo Suzuki  1 , Ryosuke Nawata  1 , Toshiki Yokoyama  1 , Sarii Tsubone  1 , Akihito Mikamo  1 , Kimikazu Hamano  1
Affiliations

Impact of the no-touch harvesting technique on the vessel diameter of saphenous vein grafts for coronary artery bypass grafting

Hiroshi Kurazumi et al. JTCVS Tech. .

Abstract

Objectives: To explore the impact of the no-touch harvesting technique on the vessel diameter of saphenous vein grafts.

Methods: This retrospective, single-center study enrolled 166 patients who underwent isolated coronary artery bypass grafting using saphenous vein grafts. Saphenous vein grafts were harvested conventionally in 83 patients (conventional group) and using the no-touch technique in 83 patients (no-touch group). We analyzed graft patency and the vessel diameters of saphenous vein grafts in the pre- and postoperative states. The diameter mismatch between the saphenous vein grafts and the coronary artery at the anastomotic site was also measured; preoperative diameter was measured using ultrasound imaging, and the postoperative diameter was measured using electrocardiogram-gated enhanced computed tomography.

Results: A total of 135 saphenous vein grafts (66 and 69 grafts in the conventional and no-touch groups, respectively) were evaluated for postoperative patency. Graft patency was equivalent in the 2 groups (conventional, 96.9% vs no-touch, 100%; P = .24). A detailed evaluation was performed in 109 saphenous vein grafts (52 and 57 grafts in the conventional and no-touch groups, respectively). Saphenous vein graft diameter was significantly distended in the conventional group (preoperative, 2.6 ± 0.7 mm vs postoperative, 3.4 ± 0.5 mm; P < .0001). However, saphenous vein graft diameter did not change in the no-touch group (preoperative, 2.9 ± 0.4 mm vs postoperative 2.8 ± 0.4 mm, P = .33). The diameter mismatch was significantly smaller in the no-touch group (conventional 1.4 ± 0.6 mm vs no-touch 1.0 ± 0.4 mm, P < .0001).

Conclusions: The no-touch technique avoids the expansion of graft diameter and diameter mismatch between the saphenous vein grafts and coronary artery.

Keywords: CABG, coronary artery bypass grafting; CT, computed tomography; NO, nitric oxide; PVAT, perivascular adipose tissue; RCA, right coronary artery; SVG, saphenous vein graft; coronary artery bypass grafting; no-touch harvesting technique; saphenous vein graft; vessel diameter.

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Figures

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Graphical abstract
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No-touch harvesting avoids expansion of the vessel diameter of saphenous vein grafts.
Figure 1
Figure 1
Study enrollment. The patency evaluation was performed in 118 patients with 135 grafts (left arm). The vessel diameter analysis was performed in 92 patients with 109 grafts (right arm). CABG, Coronary artery bypass grafting; SVG, saphenous vein graft; CT, computed tomography.
Figure 2
Figure 2
Vessel diameter measurement. A, Preoperative measurement of the SVG using ultrasound. A total of 6 points of SVG diameter were measured. Two of these 6 measured diameters, which were closest to the harvested area, were averaged and identified as the preoperative SVG diameter. B, Postoperative measurement of the SVG and coronary artery using enhanced CT. SVG diameters at 3 points, proximal, mid-, and distal portion of the SVG, were measured. The mean value of these 3 points was identified as the postoperative SVG diameter. The coronary artery diameter at 2 points, just proximal and distal sites of anastomosis, was measured. The mean value of these 2 points was identified as the postoperative coronary artery diameter. SVG, Saphenous vein graft.
Figure 3
Figure 3
Freedom from graft occlusion. The curve for the CV group is represented by a red line and that for the NT group is represented by a blue line. The 95% confidence interval for each group is shaded. NT, No-touch; CV, conventional; CI, confidence interval
Figure 4
Figure 4
Diameter of the SVG and coronary artery. A, Diameter change of the SVG for all individuals. B, Averaged diameter of the SVG and coronary artery. The curve for the CV group is represented by a dashed line, and that for the NT group is represented by a solid line. CV, Conventional; NT, no-touch; SVG, saphenous vein graft.
Figure 5
Figure 5
Summary of this study. SVG, Saphenous vein graft; CABG, coronary artery bypass grafting; CT, computed tomography.
See this image and copyright information in PMC

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