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  • The no-touch vein graft for coronary artery bypass surgery preserves the left ventricular ejection fraction at 16 years postoperatively: long-term data from a longitudinal randomised trial

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Cardiac surgery
Original research article
The no-touch vein graft for coronary artery bypass surgery preserves the left ventricular ejection fraction at 16 years postoperatively: long-term data from a longitudinal randomised trial
  1. Benny Johansson1,
  2. Ninos Samano2,
  3. Domingos Souza2,
  4. Lennart Bodin3,
  5. Derek Filbey2,
  6. John D Mannion4 and
  7. Leif Bojö5
  1. 1Department of Clinical Physiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
  2. 2Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
  3. 3Karolinska Institute, Institute of Environmental Medicine, Unit of Intervention and Implementation Research, Stockholm, Sweden
  4. 4Department of Surgery, Bayhealth Medical Center, Dover, Delaware, USA
  5. 5Department of Clinical Physiology, Central Hospital, Karlstad, Sweden
  1. Correspondence to Dr Ninos Samano; ninos.samano{at}orebroll.se

Abstract

Objectives To assess the left ventricular heart function and the clinical outcome 16 years after coronary artery bypass surgery.

Design In a randomised trial, the no-touch (NT) vein graft in coronary artery bypass surgery has shown a superior patency rate, a slower progression of atherosclerosis and better clinical outcome compared to the conventional (C) vein graft at 8.5 years. All patients at mean time 16 years were offered an echocardiographic and clinical examination.

Results In the NT-group 34 patients and in the C-group 31 patients underwent an echocardiography examination. A significantly better left ventricle ejection fraction was seen in the NT-group compared to the C-group (57.9% vs 49.4%; p=0.011). The size of the left atrium in NT was 21.7 cm2 compared to 23.9 cm2 in C; p=0.034. No patient in NT had atrial fibrillation compared to five patients in C (p=0.021). Patients with a brain natriuretic peptide value (BNP) ≥150 was 30% in NT compared to 38% in C. Total mortality was 25% in NT vs 27% in C. Cardiac-related deaths were 8% and 12% in NT and C respectively.

Conclusions The NT vein graft preserves the left ventricular ejection fraction after 16 years. A smaller left atrium, a lower BNP and no atrial fibrillation indicates an improved diastolic left ventricular function in the NT-group.

Trial registration The study is registered with clinicaltrials.gov (NCT01686100) and The Research and Development registry in Sweden (no. 102841).

  • Vein graft Disease

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/openhrt-2014-000204

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