No-Touch Saphenous Vein as Y-Composite vs Aortocoronary Graft: Early Outcome Analysis

A randomized controlled trial was designed to compare 1-year morphologic changes of the no-touch saphenous vein (SV) as a Y-composite graft (composite group) vs an aortocoronary graft (aorta group) in coronary artery bypass grafting. This study evaluated early clinical and angiographic outcomes as a preliminary analysis.

The primary end point of the trial was the intima-media thickness measured by intravascular ultrasound at 1-year angiographic follow-up. Patients were screened to enroll 25 patients in each group based on a superiority design. Early postoperative clinical and angiographic outcomes were compared between the 2 groups.

The numbers of distal anastomoses per SV graft were 2.7 ± 1.1 and 2.6 ± 0.8 in the composite and aorta groups, respectively. There was no operative death, and postoperative complications in the 2 groups did not significantly differ. All patients underwent early postoperative graft angiography at a median of 1 (interquartile range, 1-1) day after operation. Early angiographic patency rates were 98.9% (93/94 anastomoses) and 100% (90/90 anastomoses) in the composite and aorta groups, respectively. There was no distal anastomosis showing competitive flow in the aorta group, whereas 3 anastomoses with competitive flow were found in the composite group. All 3 anastomoses with competitive flow were SV grafts that were anastomosed to the right coronary artery territory with moderate stenosis.

Early clinical outcomes and angiographic graft patency rates were not significantly different with use of no-touch SV as a Y-composite graft or an aortocoronary graft.