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Increased patency with comparable mortality and revascularization risk: Is the case for no-touch vein harvesting open and shut?
  • Makoto Hibino,
  • Nitish Dhingra ,
  • Subodh Verma
Makoto Hibino
University of Toronto

Corresponding Author:[email protected]

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Nitish Dhingra
University of Toronto
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Subodh Verma
University of Toronto
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Since the introduction of the saphenous vein graft (SVG) for coronary artery bypass grafting (CABG) in 19621, the SVG has remained the most commonly used conduit to the non-LAD territories for more than half a century. However, several issues surrounding the use of SVGs, including higher graft occlusion rates and wound complications from the harvesting process, have been identified in clinical practice. As such, significant interest has been dedicated towards developing harvesting techniques that minimize the risk of these acute and late complications. In this issue of the Journal of Cardiac Surgery, Yokoyama and colleagues compared the impact of open vein harvesting (OVH), endoscopic vein harvesting (EVH) and no-touch vein harvesting (NT) on all-cause mortality, revascularization and graft failure, using a network meta-analysis based on randomized controlled trials and propensity-score matched studies. The results showed that the risk of graft failure was approximately halved amongst patients receiving NT compared with EVH and OVH; importantly, though, NT was not associated with lower all-cause mortality or revascularization risk. To further examine whether the use of NT grafts endow patients with better long-term clinical outcomes, such as mortality, myocardial infarction, and revascularization rates, a large-scaled randomized controlled trial or a patient-level combined meta-analysis is required.
25 Aug 2021Submitted to Journal of Cardiac Surgery
26 Aug 2021Assigned to Editor
26 Aug 2021Submission Checks Completed
26 Aug 2021Editorial Decision: Accept
Nov 2021Published in Journal of Cardiac Surgery volume 36 issue 11 on pages 4376-4377. 10.1111/jocs.15973