Comparative Study between Conventional and No Touch Technique Vein Graft Harvesting in Coronary Artery Bypass Surgery

Document Type : Original Research

Authors

1 Department of Cardiothoracic surgery , Faculty of Medicine, Armed Forces College of Medicine, Cairo, Egypt .

2 Department of Cardiology, millitary medical academy, Egypt.

3 Department of Cardiothoracic surgery , Faculty of Medicine, Armed Forces College of Medicine, Cairo, Egypt.

Abstract

Background: Coronary artery bypass grafting (CABG) surgery is proved to treat ischemia of the myocardium. The left internal mammary artery (LIMA) is the gold standard conduit with patency rate reaching 90% at 10 years. Compared to 50% to 70% of saphenous vein (SV) grafts patency at 10 years.. A novel no touch (NT) technique in SV harvesting with its surrounding tissue as a cushion is proposed as an alternative option, This technique leads to better endothelial preservation and nitric oxide synthase (NOS). Recent studies proposed that the NT harvesting could improve patency rate post operatively. Aim: To compare between conventional vein harvesting and no touch technique regarding patency at a period of 6 months. Subject and Methods: A total of 52 patients underwent saphenous vein graft harvesting for on pump coronary artery bypass grafting at Kobri ELKobba, 26 patients were done using the conventional method and 26 with No touch technique. Patency was assessed using MSCT after 6 months as a primary study outcome, while ECG, tropinin and leg parasthesia were regarded as secondary outcome. Results: 52 participants had multi-slice computed tomography on coronary vessels (MSCT) at 6 months after surgery. The NT group showed significant lower rates of vein graft occlusion compared to the conventional group at 6 months (11.5% of conventional method in contrast to 3.8% via no touch technique p<0.043). But had significant risk of post operative leg parathesia p<0.05. Conclusion: In comparison with the conventional vein harvesting in coronary artery bypass grafting, the NT technique showed significant increase in the patency rate of great saphenous vein and decreased the recurrence of angina but had a significant risk of post operative leg paraesthesia.

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