J Thorac Cardiovasc Surg. 2026 Jan 29:S0022-5223(26)00086-3. doi: 10.1016/j.jtcvs.2026.01.018. Online ahead of print.
ABSTRACT
OBJECTIVE: Coronary artery bypass grafting (CABG) with saphenous vein graft (SVG) is a standard treatment for coronary artery disease. The no-touch harvesting technique has shown promise in improving the durability of SVGs. This study aimed to investigate clinical outcomes and morphorogy of no-touch harvested SVGs compared to the conventionally harvested SVGs.
METHODS: Between January 2010 and December 2023, 979 patients underwent primary CABG for coronary artery disease using either no-touch (NT group; n=293) or conventionally harvested SVGs (CON group; n=689). Propensity score matching yielded 269 well-matched pairs. The long-term clinical outcomes were compared. We measured the SVG diameter and perimeter using CT in the postoperative periods within 1 month and beyond 6 months after surgery and calculated the graft-to-native ratio (GNR) defined as the SVG diameter divided by the coronary artery diameter, the mean adjacent difference (MAD) defined as the average difference between adjacent 1 mm slices and the coefficient of variation (CV) defined as the standard deviation divided by their mean.
RESULTS: In the matched groups, 5-year survival and freedom from MACCE and SVG-related events demonstrated significantly higher in the NT group than the CON group (89.8% vs 79.5%, P<0.001, 85.1% vs. 74.7%, P=0.014, 84.8% vs. 64.8%, P<0.001). In the late phase, the NT group showed fewer large-GNR (≥3.2) grafts and lower MAD and CV, indicating smoother luminal surfaces.
CONCLUSIONS: In the long-term, no-touch SVGs improve clinical outcomes, provide appropriate graft diameter for coronary arteries and maintain luminal smoothness.
PMID:41619805 | DOI:10.1016/j.jtcvs.2026.01.018