Background. We have observed reopening of the occluded “no-touch”
saphenous vein (NT SV) composite grafts on follow-up angiograms in
patients who underwent coronary artery bypass graftings (CABG). Methods.
Between 2008 and 2018, 1283 patients received NT SV conduits without or
with surrounding pedicle tissue as composite grafts based on the in situ
left internal thoracic artery (ITA) for CABG and underwent early
postoperative angiographies. Among the 1283 patients, 53 patients showed
55 occluded SV conduit anastomoses, and 46 patients who had 48 occluded
SV anastomoses were re-evaluated by 1-year postoperative angiographies.
Results. Early postoperative angiographies in 1283 patients demonstrated
overall occlusion rates of 1.2% (56/4518); occlusion rates of the ITA
and SV were 0.08% (1/1259) and 1.7% (55/3260), respectively. One-year
angiograms demonstrated that 14 occluded SV anastomoses (29.2% [14/48
occluded SV]) of 14 patients became patent. Reopening of occluded SV
conduits occurred more frequently in NT SV with pedicle tissue than in
NT SV without pedicle tissue (45.0% [9/20] versus 17.9%
[5/28]; P=0.057). When we examined the preoperative and 1-year
postoperative angiograms, reopening of the occluded SV conduits was not
related with progression (P=0.258) or preoperative reversibility score
(P=0.115) of native target coronary artery disease. Conclusions. More
than a quarter of the occluded SV composite grafts on early
postoperative angiograms were patent in the 1-year angiograms. The
reopening rates were higher in patients who had received NT SV conduits
with pedicle tissue than those who had received NT SV conduits without
pedicle tissue.
Left internal thoracic artery and saphenous vein composite grafts: The value of valveless veins
