Short- and mid-term clinical outcomes of harmonic scalpel-assisted no-touch technique of the saphenous vein grafts harvesting in coronary bypass grafting

TL;DR

This study shows that using a harmonic scalpel to harvest saphenous vein grafts improves surgical efficiency and heart function recovery in patients undergoing coronary bypass surgery.

Contribution

The novel use of a harmonic scalpel in a modified 'no-touch' technique for harvesting saphenous vein grafts is introduced and evaluated.

Findings

The modified no-touch technique reduced graft acquisition time and pulsatility index significantly.

The modified technique showed higher left ventricular ejection fraction at 24 months.

No significant difference was found in graft flow or complication rates between the two techniques.

Abstract

The “No-touch” technique has demonstrated efficacy in enhancing both short-term and long-term patency of great saphenous vein grafts (SVG) for coronary heart disease (CHD) treatment. Nevertheless, its widespread use is constrained by the method’s limitations. Therefore, we modified it by using a harmonic scalpel to harvest SVG and verified its patency rate.

156 patients who underwent coronary artery bypass grafting (CABG) were consecutively recruited between November 2018 and July 2019. Patients were allocated to 2 groups of 78 each, according to two SV harvesting techniques (modified no-touch [M group] and conventional technique [C group]). SVG samples were taken for pathological examination. This study was conducted according to the guidelines of the Declaration of Helsinki and was approved by the Ethics Committee of Shanghai Tenth People’s Hospital (ChiCTR1800018433). All patients underwent follow-ups for at least 2 years.

The modified no-touch technique reduced graft acquisition time (P < 0.001) and the pulsatility index (PI) (P < 0.001). No difference was detected in the average flow of grafts and procedural complication rate. At 24 months, the left ventricular ejection fraction (LVEF) was higher in the M-group (P < 0.001).

The use of the harmonic scalpel to harvest SVG is safe and effective, and may contribute to better postoperative cardiac function recovery, as reflected by satisfactory short- and mid-term outcomes.

The online version contains supplementary material available at 10.1186/s13019-025-03823-x.

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