No-Touch Saphenous Vein Harvesting May Improve Further the Patency of Saphenous Vein Composite Grafts: Early Outcomes and 1-Year Angiographic Results

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No-Touch Saphenous Vein Harvesting May Improve Further the Patency of Saphenous Vein Composite Grafts: Early Outcomes and 1-Year Angiographic Results Yong Han Kim, MD, Hong Chul Oh, MD, Jae Woong Choi, MD, Ho Young Hwang, MD, Ki-Bong Kim, MD, PhD The Annals of Thoracic Surgery Volume 103, Issue 5, Pages 1489-1497 (May 2017) DOI: 10.1016/j.athoracsur.2016.09.024 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Summary flow diagram of enrolled patients. (CABG = coronary artery bypass graft surgery; ITA = internal thoracic artery; MM = minimally manipulated Y-composite graft; NT = no touch Y-composite graft; RGEA = right gastroepiploic artery; SV = saphenous vein.) The Annals of Thoracic Surgery 2017 103, 1489-1497DOI: (10.1016/j.athoracsur.2016.09.024) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) No touch and (B) minimally manipulated saphenous vein composite grafts based on the in situ left internal thoracic artery. The Annals of Thoracic Surgery 2017 103, 1489-1497DOI: (10.1016/j.athoracsur.2016.09.024) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A, B) Competitive saphenous vein (SV [white arrow]) composite graft flow on early angiogram in a 64-year-old man. No-touch SV conduit was anastomosed to the first and third obtuse marginal arteries (OM1 and OM3 [black arrowheads]) and posterior descending artery (PDA [white arrowhead]); however, the PDA and SV conduit distal to the OM3 were not visualized on the graft angiogram. The SV anastomosed to the PDA was retrograde on native right coronary angiogram. (C) No-touch SV composite graft anastomosed to the PDA was patent on 1-year angiogram. (LAD = left anterior descending coronary artery; LITA = left internal thoracic artery.) The Annals of Thoracic Surgery 2017 103, 1489-1497DOI: (10.1016/j.athoracsur.2016.09.024) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Freedom from major adverse cardiac and cerebrovascular event (MACCE) between no-touch (NT) group (black lines) and minimally manipulated (MM) group (gray lines) for (A) all patients and (B) matched patients. The Annals of Thoracic Surgery 2017 103, 1489-1497DOI: (10.1016/j.athoracsur.2016.09.024) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions