Related Experiment Video
Updated: May 3, 2026
Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
Evaluation of coronary artery-saphenous vein composite grafts: the aortic no-touch technique
Isa Coskun1, Yucel Colkesen, Orhan Saim Demirturk
1Departments of Cardiovascular Surgery (Drs. Coskun, Demirturk, Gulkan, Tunel, and Turkoz) and Cardiology (Dr. Colkesen), Baskent University, 01250 Adana, Turkey.
Insights
The aortic no-touch technique using composite grafts is a safe option for coronary artery bypass grafting (CABG) in patients with ascending aorta atherosclerosis. Outcomes, including survival and reintervention rates, were similar to conventional CABG.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Cardiac Surgery
Background:
- Coronary artery bypass grafting (CABG) is a standard treatment for coronary artery disease.
- Atherosclerosis of the ascending aorta poses a challenge for conventional CABG due to clamping risks.
- The aortic no-touch technique aims to mitigate these risks by avoiding aortic manipulation.
Purpose of the Study:
- To compare the outcomes of the aortic no-touch technique with conventional CABG in patients with ascending aorta atherosclerosis.
- To evaluate early and late survival, reintervention-free survival, and freedom from cardiac death.
Main Methods:
- Retrospective study comparing 120 patients undergoing aortic no-touch CABG with 240 propensity-score-matched controls undergoing conventional CABG.
- Data collected from 2003-2012, with a mean follow-up of 5.27 years.
- Comparison of mortality, cardiac death, overall survival, and reintervention rates.
Main Results:
- No significant differences in early or late mortality rates between the two groups (P=0.19 vs P=0.29).
- Similar rates of cardiac-related death (2.5% vs 2.1%) and overall death (8.3% vs 7.9%).
- Comparable overall survival (91.7% vs 92.1%), freedom from cardiac death (97.4% vs 97.5%), and reintervention-free survival (96.7% vs 98.8%).
Conclusions:
- The aortic no-touch technique with composite grafts is a viable alternative for CABG in patients with atherosclerotic ascending aortas.
- This technique offers comparable safety and efficacy to conventional CABG in this specific patient population.
- It may be a reasonable option when aortic clamping is contraindicated.
Abstract:
We retrospectively compared the results of conventional coronary artery bypass grafting (CABG) performed on patients who showed no preoperative evidence of serious atherosclerosis of the ascending aorta with the results of the aortic no-touch technique (using coronary artery-saphenous vein composite grafts) on CABG patients who did show such evidence. From 2003 through 2012, 3,152 consecutive patients underwent isolated primary CABG at our hospital. We chose 360 for the current study. The study group (n=120) comprised patients who had undergone operation via the aortic no-touch technique. Propensity-score-matching (1:2) was used to select the control group of 240 patients who had undergone conventional CABG. Early and late survival rates, reintervention-free survival rates, and freedom from cardiac death were compared. Early and late mortality rates were similar in the study and control groups (P=0.19 vs P=0.29, respectively), as were cardiac-related death (2.5% vs 2.1%, respectively; P=0.53) and overall death (8.3% vs 7.9%, respectively; P=0.51). Overall survival rates were 91.7% vs 92.1% and freedom-from-cardiac-death rates were 97.4% vs 97.5% (P=0.71 vs P=0.78, respectively; mean follow-up period, 5.27 ± 2.51 yr). Reintervention-free survival rates were also similar (96.7% vs 98.8%, respectively; P=0.2). As a result of the similar rates of early and late survival, reintervention-free survival, and freedom from cardiac death, we conclude that the aortic no-touch technique with composite grafts might be a reasonable option in patients who have atherosclerotic ascending aorta that cannot be clamped.
