Document Detail


Harvesting the saphenous vein with surrounding tissue for CABG provides long-term graft patency comparable to the left internal thoracic artery: results of a randomized longitudinal trial.
MedLine Citation:
PMID:  16872965     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Conventional harvesting of the saphenous vein in coronary artery bypass surgery produces vessel damage that contributes to graft failure. A novel "no touch" technique provides high short- and long-term patency rates. METHOD: This randomized longitudinal trial compares graft patency of two patient groups undergoing coronary artery bypass surgery. Conventional: 52 patients had their veins stripped, distended, and stored in saline solution. No-touch: 52 patients had veins removed with surrounding tissue, not distended, and stored in heparinized blood. Angiographic assessment was performed at mean time 18 months after the operation in 46 patients in the conventional group and 45 patients in the no-touch group and repeated at mean time 8.5 years in 37 patients from both groups. RESULTS: The distribution of the grafts to the recipient coronary arteries regarding their size and quality was similar in both groups. The angiographic assessment at 18 months postoperatively showed 89% conventional versus 95% no-touch grafts were patent. Repeated angiography at 8.5 years showed a patency rate for the conventional group of 76% and 90% for the no-touch group (P = .01). The multivariate analysis showed that the most important surgical factors for graft patency were the technique of harvesting (odds ratio= 3.7, P = .007) for the no-touch versus the conventional technique and the vein quality before implantation (odds ratio = 3.2, P = .007) for veins that were of good quality. By comparison the patency of the thoracic artery grafts was 90%. CONCLUSION: Harvesting the saphenous vein with surrounding tissue provides high short- and long-term patency rates comparable to the left internal thoracic artery.
Authors:
Domingos S R Souza; Benny Johansson; Leif Bojö; Roland Karlsson; Håkan Geijer; Derek Filbey; Lennart Bodin; Mikael Arbeus; Michael R Dashwood
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  132     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-28     Completed Date:  2006-09-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  373-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiothoracic Surgery and Anesthesiology, Orebro University Hospital, SE-701 85 Orebro, Sweden. domingos.souza@orebroll.se
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MeSH Terms
Descriptor/Qualifier:
Coronary Angiography
Coronary Artery Bypass*
Female
Humans
Logistic Models
Male
Mammary Arteries / transplantation
Middle Aged
Multivariate Analysis
Saphenous Vein / transplantation*
Suture Techniques
Tissue and Organ Harvesting / methods*
Treatment Outcome
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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