Sequential Saphenous Vein Coronary Bypass Grafting.

Area of Science:

• Cardiovascular Surgery
• Vascular Grafting
• Coronary Artery Bypass Grafting (CABG)

Background:

• Sequential saphenous vein (SV) grafting is a common technique in coronary artery bypass grafting (CABG).
• Previous research has primarily focused on the safety and efficacy of sequential SV grafting, with limited attention to the impact of the number of distal anastomoses on graft patency.

Purpose of the Study:

• To evaluate the impact of three versus two distal anastomoses per single SV conduit on SV graft patency after off-pump CABG.
• To identify independent risk factors for sequential SV graft failure.

Main Methods:

• A single-center retrospective study involving 1320 patients undergoing off-pump CABG between January 2011 and December 2014.
• Patients were divided into two groups: a triple group (n=758) with three distal anastomoses and a double group (n=562) with two distal anastomoses per SV conduit.
• The primary endpoint was SV graft failure assessed over a 2-year follow-up period.

Main Results:

• No significant difference in the overall patency rate of sequential SV conduits was observed between the triple and double groups (86.5% vs. 87.1%, P=0.757).
• The number of distal anastomoses (three versus two) was not a significant predictive factor for follow-up SV graft failure (HR=0.91, 95% CI: 0.66-2.29, P=0.137).
• Both groups demonstrated similar rates of freedom from repeat revascularization at follow-up (log-rank P=0.170).

Conclusions:

• Utilizing three versus two distal anastomoses per single SV conduit results in comparable SV graft patency.
• The number of distal anastomoses in sequential SV grafting is not an independent risk factor for graft failure after off-pump CABG.