Fifteen-year patency and 18-year clinical outcomes after surgical revascularization using saphenous vein composite grafts to total arterial grafts.

Abstract

To compare 15-year graft patency and 18-year clinical outcomes after coronary artery bypass grafting (CABG) using no-touch saphenous vein (NT-SV) composite grafts based on the left internal thoracic artery and after CABG using arterial composite grafts. Patients who underwent primary isolated off-pump CABG between January 2006 and December 2009 were screened for study eligibility. The NT-SV composite grafts were used in 215 patients (SV group). Fifteen-year graft patency rates and 18-year clinical outcomes were evaluated. These results were compared with 419 patients who underwent surgery using total arterial composite grafts (TAC group). A total of 634 patients (mean age, 65.1 ± 8.9 years, 455 males and 179 females) were enrolled. The average number of distal anastomoses was 3.3 ± 0.8. The competing risk-adjusted 15-year patency rate of the NT-SV composite grafts was 91.7%, not significantly different from that of the arterial composite grafts in the TAC group (84.8%; P = .144). In addition, there were no significant differences in absolute 15-year patency rates of overall and composite grafts between the 2 groups. Clinical outcomes, such as overall survival and cumulative incidence of major adverse cardiac events up to 18 years, were not significantly different between the 2 groups. Propensity score matching yielded 176 pairs of patients from the 2 groups. There were no significant differences in either 15-year graft patency or 18-year clinical outcomes between the propensity score-matched groups. Results of CABG using the NT-SV composite grafts were comparable to those of CABG using arterial composite grafts in terms of 15-year patency and 18-year clinical outcomes.