Related Experiment Video
Updated: Jun 16, 2026
Establishment and Evaluation of a Porcine Vein Graft Disease Model
Published on: July 25, 2022
Off-pump right coronary artery bypass with saphaneous vein or in-situ right internal thoracic artery
Gijong Yi1, Young-Nam Youn, Suk-Won Song
1Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Seoul, Korea.
Insights
Saphenous vein grafts demonstrate superior patency for moderate right coronary artery stenosis during off-pump bypass surgery compared to in situ right internal thoracic artery grafts. Further research is needed for long-term outcomes.
Area of Science:
- Cardiovascular Surgery
- Vascular Grafting
- Coronary Artery Bypass Grafting
Background:
- The optimal conduit for right coronary artery (RCA) bypass remains under investigation.
- Comparing in situ right internal thoracic artery (RITA) with free saphenous vein (SV) grafts for RCA in off-pump coronary artery bypass graft surgery (OPCABG) is crucial.
Purpose of the Study:
- To compare clinical outcomes between RITA in situ and free SV grafts for RCA in OPCABG.
- To evaluate graft patency and reintervention rates based on native RCA stenosis severity.
Main Methods:
- Retrospective analysis of 358 patients undergoing isolated OPCABG.
- Graft patency and RCA reintervention rates assessed over a mean follow-up of 57.6 months.
- Comparison stratified by the degree of native RCA stenosis.
Main Results:
- No significant differences in overall mortality or major adverse cardiac and cerebrovascular events.
- 5-year freedom from graft occlusion was higher in the SV group (94.3%) vs. RITA group (87.4%), particularly in moderate stenosis (<75%) cases (p=0.020).
- 5-year freedom from RCA reintervention showed a trend favoring SV grafts (99.3%) over RITA (95.7%).
Conclusions:
- Both RITA and SV grafts offer favorable patency for RCA in OPCABG.
- SV grafts exhibit superior patency in patients with moderate RCA stenosis compared to in situ RITA.
- Extended follow-up is recommended to further elucidate long-term graft performance.
Background:
The ideal conduit for the right coronary artery (RCA) is yet to be determined. The purpose of this study was to compare the clinical results between the right internal thoracic artery (RITA) in situ with free saphenous vein (SV) graft for RCA in off-pump coronary artery bypass graft surgery (OPCABG).
Methods:
Three hundred and fifty-eight patients who underwent isolated OPCABG with RCA anastomosis either by RITA in situ (n = 199) or free SV graft (n = 159) were included. We evaluated the graft patency and the incidence of RCA reintervention considering the degree of native RCA stenosis. The follow-up rate was 97.8%, and the mean follow-up duration was 57.6 months.
Results:
The overall mortality and the incidence of major cardiac and cerebrovascular event showed no difference between the two groups (p = 0.495 and p = 0.338, respectively). The 5-year freedom from graft occlusion rate was 87.4% +/- 3.2% in the RITA group and 94.3% +/- 2.0% in the SV group (p = 0.011), with a statistically significant difference only in the moderate stenosis (< 75%) group (p = 0.020). The 5-year freedom from RCA reintervention rate was 95.7% +/- 1.6% in the RITA group and 99.3% +/- 0.7% in the SV group (p = 0.055).
Conclusions:
Both RITA and SV showed favorable graft patency for the RCA system in OPCABG. The SV graft showed better patency in patients with moderate stenosis of RCA compared with RITA in situ. A longer follow-up period is necessary to clarify our current results.
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