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Clinical Outcomes After Surgical Revascularization Using No-Touch Versus Conventional Saphenous Vein Grafts: Mid-Term Follow-Up of Propensity Score Matched Cohorts
- Source :
- Weiss, M G, Nielsen, P H, James, S, Thelin, S & Modrau, I S 2023, ' Clinical outcomes after surgical revascularization using no-touch versus conventional saphenous vein grafts : Mid-term follow-up of propensity score matched cohorts ', Seminars in Thoracic and Cardiovascular Surgery, vol. 35, no. 2, pp. 228-236 . https://doi.org/10.1053/j.semtcvs.2021.12.002
- Publication Year :
- 2023
- Publisher :
- Elsevier BV, 2023.
-
Abstract
- Previous studies have demonstrated superior patency of no-touch as compared to conventional saphenous vein grafts in coronary artery bypass grafting. We aimed to compare mid-term clinical outcomes of both techniques in a large cohort of routine patients. We identified all patients undergoing non-emergent primary coronary artery bypass grafting with either no-touch or conventional saphenous vein grafts at our institution between 2000 and 2020. Propensity score matching was used to create adjusted cohorts based on 5,288 eligible patients. The primary outcome was the combined endpoint of all-cause mortality and repeat revascularization. Secondary outcomes were individual rates of all-cause mortality and repeat revascularization, surgical complications, and short-term mortality. Propensity score matching resulted in cohorts of no-touch (n=923) and conventional (n=923) saphenous vein grafted patients with comparable baseline characteristics. Mean follow-up time was significantly shorter for the no-touch compared to the conventional cohort (4.9 ± 2.3 versus 8.3 ± 2.6 years, p< 0.001). Up to seven-year follow-up, neither the rate of the primary composite endpoint nor death differed significantly between the cohorts. The rate of repeat revascularization was significantly higher in patients in the no-touch cohort (12.9% versus 9.3% at seven-year follow-up, p=0.022. Post-hoc analysis of percutaneous coronary intervention during follow-up revealed comparable rates of saphenous vein graft failure (no-touch 42/923 (4.6%) versus conventional 32/923 (3.5%), p=0.286). In this large propensity score matched registry study, coronary artery bypass with no-touch compared to conventional saphenous vein grafting did neither enhance mid-term survival nor reduce the rate of repeat revascularization.
- Subjects :
- Pulmonary and Respiratory Medicine
Kardiologi
Mid-term follow-up
Kirurgi
Saphenous Vein/transplantation
No-touch saphenous vein grafts
Coronary artery bypass graft surgery
General Medicine
Coronary Angiography
Treatment Outcome
Propensity score matching
Clinical outcomes
Humans
Cardiac and Cardiovascular Systems
Surgery
Propensity Score
Cardiology and Cardiovascular Medicine
Vascular Patency
Follow-Up Studies
Subjects
Details
- ISSN :
- 10430679
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Seminars in Thoracic and Cardiovascular Surgery
- Accession number :
- edsair.doi.dedup.....e2f9d06db29742db46187516de68c5d1