No-touch saphenous vein graft harvesting technique for coronary artery bypass grafting

Gen Thorac Cardiovasc Surg. 2020 Mar;68(3):248-253. doi: 10.1007/s11748-019-01186-4. Epub 2019 Aug 2.

Abstract

Objectives: Although the patency of internal artery grafts in coronary artery bypass grafting (CABG) is superior to that of saphenous vein grafts (SVGs), good long-term patency rates have been reported with SVGs harvested using the no-touch technique. Here, we report the early results of CABG with no-touch SVGs (NT-SVGs) along with the precautions required while handling these grafts.

Methods: This retrospective study included 41 patients who underwent CABG with NT-SVGs between May 2016 and March 2018. NT-SVGs were harvested with minimal electric scalpel use, and post-harvesting vascular overdilation with a syringe was not performed. Blood with heparinized saline was used to prevent vascular endothelial damage. A drain was inserted into the SVG harvest site, which was closed with a single interrupted suture, and elasticated bandage and compression stockings were used to prevent fluid retention and avoid delayed wound healing.

Results: There was no case of postoperative thoracotomy due to bleeding or myocardial infarction, and postoperative graft assessment confirmed graft patency in all patients, with a little mismatch between the diameters of SVG and the anastomotic vessel. Delayed wound healing at the graft harvest site seemed to improve after introducing the above procedures.

Conclusions: Early results of CABG with NT-SVGs were good. Some precautions must be taken during harvesting and anastomosis. Taking precautions described in this study may help reduce the risk of perioperative complications and make the no-touch technique the standard procedure for harvesting SVGs for CABG.

Keywords: Coronary artery bypass grafting; No-touch technique; Saphenous vein graft.

MeSH terms

  • Aged
  • Coronary Angiography
  • Coronary Artery Bypass / methods*
  • Endothelium, Vascular
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction
  • Retrospective Studies
  • Saphenous Vein / transplantation*
  • Stockings, Compression
  • Thoracotomy
  • Vascular Patency*
  • Vascular Surgical Procedures / methods*
  • Wound Healing