Gabriele Ferrari

and 5 more

Objectives: To compare health-related quality of life of patients primarily treated with a no-touch saphenous vein graft with that of patients who received a conventional graft. Methods: The study included all individuals treated with a percutaneous coronary intervention on a saphenous vein graft between January 2006 and June 2020. The RAND-36 health survey was used to assess health-related quality of life. The Mann–Whitney U test was used to test differences in health-related quality of life between the two groups. Effect size was estimated via Cohen’s d. The average treatment effect between the groups was tested by propensity score matching. Results: Of the 346 patients treated with a percutaneous coronary intervention in a stenosed or occluded saphenous vein graft, 165 responded to RAND-36 (no-touch: n=48; conventional: n=117). Patients with a no-touch graft reported better mean values on seven of the eight health survey domains. Statistically significant differences were observed for four of the domains, all in favour of the no-touch group. The effect size estimates indicated a small difference for five domains, with the largest values (>0.40) seen for the general health and energy/fatigue domains. Propensity score matching confirmed a statistically significant difference for the physical functioning and general health domains. Conclusions: At a mean follow-up of 5.4 years, patients who received a percutaneous coronary intervention in no-touch vein grafts showed significantly better health-related quality of life than those who received a percutaneous coronary intervention in conventional vein grafts.

Mikael Arbeus

and 6 more

Background Randomised trials show high long-term patency for no-touch saphenous vein grafts in coronary artery bypass grafting. The patency rate in off-pump coronary bypass surgery for these grafts has not been investigated. Our centre participated in the CORONARY randomized trial, NCT00463294. This is a sub-study aimed to assess the patency of no-touch saphenous veins in on- versus off-pump coronary bypass surgery at five-year follow-up. Methods Fifty-six patients were included. Forty of 49 patients, alive at five years, participated in this follow-up. There were 21 and 19 patients in the on- and off-pump groups respectively. No-touch saphenous veins were used to bypass all targets and in some cases the left anterior descending artery. Graft patency according to distal anastomosis was evaluated with computed tomography angiography. Results The five-year patency rate was 123/139 (88.5%). The patency for the no-touch vein grafts was 57/64 (89.1%) in the on-pump vs 37/45 (82.2%) in the off-pump group. All left internal thoracic arteries except for one, 29/30 (96.6%), were patent. All vein grafts used to bypass the left anterior descending and the diagonal arteries were patent 32/32. The lowest patency rate for the saphenous veins was to the right coronary territory, particularly in off-pump surgery (80.0% vs 62.5% for the on- respective off-pump groups). Conclusions Comparable five-year patency for the no-touch saphenous veins and the left internal thoracic arteries to the left anterior descending territory in both on- and off-pump coronary artery bypass grafting. Graft patency in off-pump CABG is lower to the right coronary artery.