Assessment of Graft Patency Between Pedicled Saphenous Vein and Conventional Saphenous Vein Conduits for Coronary Artery Bypass Surgery

  • Md. Nahedul Morshed Registrar, Cardiac Surgery Department, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh
  • Dewan Iftakher Raza Choudhury Assistant Professor & Consultant of Cardiac Surgery, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh
  • Apurbo Kumar Choudhary Indoor Medical Officer, Sher-E-Bangla Medical College Hospital, Barishal, Bangladesh
  • Nittyananda Pal Registrar, Cardiac Surgery Department, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh
  • Ahmad Pear Salauddin Registrar, Cardiac Surgery Department, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh
  • Noor -E-Elahi Assistant Registrar, Cardiac Surgery Department, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Farooque Ahmed Professor & Chief Cardiac Surgeon, Cardiac Surgery Department, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh
Keywords: Graft Patency, Pedicled Saphenous, Conventional Saphenous Vein Conduits

Abstract

Introduction: The long-term successes of coronary artery bypass graft surgery depends on continued patency of the bypass conduits. After coronary artery bypass graft, however, the saphenous vein grafts show a high incidence of accelerated atherosclerosis. A major contributing factor to the early atherosclerotic process is damage to the vessel wall, especially endothelial injury that occurs during the conventional harvesting of the vein, using high- pressure distension. A new pedicled saphenous vein technique, the saphenous vein is harvested with its pedicled of surrounding tissue, preserves the entire vein wall including the vasa vasorum.

Objective: To determine the patency rate in between pedicled saphenous vein and Conventional saphenous vein by coronary computed tomography angiogram.

Methods: This comparative cross-sectional study was carried out at the department of cardiac surgery in National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh. The period of study was from January, 2019 to September, 2020 and purposive sampling method was applied for this study. The study population was 80, with two groups having 40 patients each. Grouping of patients were done by purposive sampling method and all patients underwent elective coronary artery bypass graft in 2015. These group of patients again investigated through coronary computed tomography angiogram in 2020 for evaluation of saphenous vein patency and occlusion rate. Data was collected by using a standardized semi- structured questionnaire, face to face interview and hospital records.

Results: After five years postoperative follow up through the coronary computed tomography angiographic assessment showed 91.92% patency rate of pedicled saphenous vein grafts compared to 85.56% patency rate of conventional saphenous vein grafts. Similarly, the proportion of study saphenous vein grafts with total occlusion were higher in conventional saphenous vein grafts than pedicled saphenous vein grafts, but that was not statistically significant [Group A: 08 venous grafts occluded out of 99 venous grafts (8.08%); Group B: 13 venous grafts occluded out of 90 venous grafts (14.44%), p= 0.209].

Conclusion: This study was concluded that, pedicled saphenous vein has higher patency rate than conventional vein. It has also significantly slower progression of occlusion in pedicled vein grafts.

 

 

 

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Author Biographies

Md. Nahedul Morshed, Registrar, Cardiac Surgery Department, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh

 

 

 

Dewan Iftakher Raza Choudhury, Assistant Professor & Consultant of Cardiac Surgery, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh

 

 

Apurbo Kumar Choudhary, Indoor Medical Officer, Sher-E-Bangla Medical College Hospital, Barishal, Bangladesh

 

 

Nittyananda Pal, Registrar, Cardiac Surgery Department, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh

 

 

Ahmad Pear Salauddin, Registrar, Cardiac Surgery Department, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh

 

 

Noor -E-Elahi, Assistant Registrar, Cardiac Surgery Department, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh

 

 

Farooque Ahmed, Professor & Chief Cardiac Surgeon, Cardiac Surgery Department, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh

 

 

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Papakonstantinou, N. A., Baikoussis, N. G., Goudevenous, J., Papadopoulos, G., Apostolakis, E., (2016) Novel no touch technique of saphenous vein harvesting:Is great graft patency rate provided?. Annals of Cardiac Anaesthesia, Vol.19, pp. 481-486.

Johansson, B.L., Souza, D. S., Bodin, L., Filbey, D., Loesch, A., Geijer, H., et al. (2010) Slower progression of atherosclerosis in vein grafts harvested with 'no touch' technique compared with conventional harvesting technique in coronary artery bypass grafting: an angiographic and intravascular ultrasound study. European Journal of Cardiothoracic Surgery. Vol.38, pp.414–419.

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Samano, N., Geijer, H., Liden, M., Fremes, S., et al (2015) The non-touch saphenous vein for coronary artery bypass grafting maintain a patency, after 16 years, comparable to the left internal thoracic artery: A randomized trial. The Journal of Thoracic and Cardiovascular Surgery, Vol.13, pp.219-228.

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CITATION
DOI: 10.26838/MEDRECH.2023.10.1.686
Published: 2023-02-25
How to Cite
1.
Morshed MN, Choudhury DIR, Choudhary AK, Pal N, Salauddin AP, E-Elahi N, Ahmed F. Assessment of Graft Patency Between Pedicled Saphenous Vein and Conventional Saphenous Vein Conduits for Coronary Artery Bypass Surgery. Med. res. chronicles [Internet]. 2023Feb.25 [cited 2024Jul.13];10(1):132-9. Available from: https://medrech.com/index.php/medrech/article/view/666
Section
Original Research Article