# The Clinical Utility of No-Touch Saphenous Vein Grafting as a Second Conduit in Multivessel Coronary Artery Bypass Surgery

## TL;DR

This study compares the effectiveness of a no-touch saphenous vein graft in heart bypass surgery with other graft types, finding it performs well over five years.

## Contribution

The study introduces evidence that the no-touch saphenous vein graft has superior patency compared to conventional grafts in non-LAD coronary artery bypass surgery.

## Key findings

- NT-SVG showed 96.4% 5-year patency, higher than cSVG and rGEA.
- NT-SVG patency was comparable to in situ and free ITA grafts.
- Hospital mortality was low at 1.5% with good long-term survival rates.

## Abstract

We aimed to compare the midterm outcomes of the no-touch saphenous vein graft (NT-SVG) as a second conduit with those of other graft types.

We retrospectively reviewed 549 consecutive patients who underwent multivessel isolated coronary artery bypass grafting (CABG) with ≥2 distal anastomoses between 2002 and 2024. Five conduit groups for non-LAD grafting were analyzed: in situ internal thoracic artery (ITA), free ITA, conventional saphenous vein graft (cSVG), NT-SVG, and right gastroepiploic artery (rGEA). We analyzed conduit-specific patency and propensity score–matched patency between cSVG and NT-SVG.

The mean age was 68.6 ± 9.5 years, and 74% were men. Off-pump CABG was performed in 60.5% of cases, with a mean of 3.3 ± 0.9 distal anastomoses. Hospital mortality was 1.5%. Notably, the 5- and 10-year survival rates were 85.9% and 74.1%, respectively. Among 794 non-LAD grafts, the NT-SVG demonstrated a 5-year patency of 96.4%, which was significantly higher than that of cSVG (89.5%, p = 0.05) and rGEA (87.2%, p = 0.04), and equivalent to in situ ITA (94.4%) and free ITA (95.0%). The propensity score–matched analysis further demonstrated superior graft patency with the NT-SVG.

The NT-SVG achieves a 5-year patency comparable to that of ITA grafts and superior to that of cSVG and rGEA, suggesting its potential as a promising option for non-LAD revascularization, pending further validation.