T-graft (Saphenous Vein to LIMA) in Minimally Invasive Coronary Artery Bypass Grafting in Patients with Coronary Artery Disease
Abstract
Aim: To assess the efficacy and safety of using the T-graft (vein to LIMA) for minimally invasive coronary artery bypass grafting (MICS CABG) in patients with coronary artery disease.
Methods: 1,111 patients who underwent MICS CABG in the period from October 2012 to February 2023 were retrospectively reviewed. Of them, 36 (3.2%) patients with constructed T-grafts were enrolled in the study. The primary endpoint was mortality and the secondary endpoints were myocardial infarction, stroke, and wound infections. The mean age of patients was 67.9±14.2 years (48 to 85 years). Gender: men – 24 (66.6%), women – 12 (33.4%). The mean EuroSCORE II was 3.6±1.4.
Results: There were no cases of death in the study group. All patients underwent off-pump MICS CABG. The mean operation time was 136±34 min. The mean number of the distal anastomoses was 2. There were no cases of postoperative bleeding, wound infection, and stroke. The mean length of the ICU stay was 1.7±0.7 days. The mean length of the in-hospital stay was 7.9±1.2 days. The median follow-up was 42.4 months (95% CI 36.4.1–46.7). The Kaplan-Meier estimator showed 97.8% survival rate within 36 months (95% CI 97.1–99).
Conclusion: Using of a T-graft in MICS CABG for myocardial revascularization is an effective and safe procedure with superior immediate and medium-term outcomes in patients with coronary artery disease.
About the Authors
Y. A. Schneider
Federal State Budgetary Institution “Federal Сenter for High Medical Technologies”, Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Schneider Yuri A., M.D., Ph.D., Professor, Medical Director
4, Kaliningradskoe Av., Rodniki, Guryevsky district, Kaliningrad region, 236035
V. G. Tsoi
Federal State Budgetary Institution “Federal Сenter for High Medical Technologies” Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Tsoi Victor G., M.D., Deputy Director for Surgery, Head of Cardiac Surgery Department №1
4, Kaliningradskoe Av., Rodniki, Guryevsky district, Kaliningrad region, 236035
M. S. Fomenko
Federal State Budgetary Institution “Federal Сenter for High Medical Technologies” Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Fomenko Mikhail S., M.D., Ph.D., cardiovascular surgeon at the Cardiac Surgery Department №1
4, Kaliningradskoe Av., Rodniki, Guryevsky district, Kaliningrad region, 236035
A. A. Pavlov
Federal State Budgetary Institution “Federal Сenter for High Medical Technologies” Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Pavlov Alexander A., M.D., cardiovascular surgeon at the Cardiac Surgery Department №1
4, Kaliningradskoe Av., Rodniki, Guryevsky district, Kaliningrad region, 236035
P. A. Shilenko
Federal State Budgetary Institution “Federal Сenter for High Medical Technologies” Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Shilenko Pavel A., M.D., cardiovascular surgeon at the Cardiac Surgery Department №1
4, Kaliningradskoe Av., Rodniki, Guryevsky district, Kaliningrad region, 236035
References
1. Head SJ, Milojevic M, Daemen J, et al. Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. // Lancet 2018;391:939-48. doi: 10.21037/jtd.2018.08.127
2. Kopjar T, Dashwood MR, Dreifaldt M, de Souza DR. Notouch saphenous vein as an important conduit of choice in coronary bypass surgery. // J Thorac Dis. 2018 Sep;10(Suppl 26):S3292-S3296. doi: 10.21037/jtd.2018.08.127.
3. Kim MS, Hwang HY, Kim JS, Oh SJ, Jang MJ, Kim KB. Saphenous vein versus right internal thoracic artery as a Y-composite graft: Five-year angiographic and clinical results of a randomized trial. // J Thorac Cardiovasc Surg. 2018 Oct;156(4):1424-1433.e1. doi: 10.1016/j.jtcvs.2018.04.123.
4. Kim MS, Kim KB. Saphenous Vein Versus Right Internal Thoracic Artery as a Y-Composite Graft: TenYear Angiographic and Long-Term Clinical Results of the SAVE RITA Trial. // Circulation. 2021 Oct 5;144(14):1186- 1188. doi: 10.1161/CIRCULATIONAHA.121.056438.
5. Kim KB, Hwang HY, Kim MS. Techniques and Outcomes of the No-Touch Vein Conduit as a Y-Composite Graft. // Braz J Cardiovasc Surg. 2022 Sep 2;37(Spec 1):38-41. doi: 10.21470/1678-9741-2022-0119.
6. Hwang HY, Lee Y, Sohn SH, Choi JW, Kim KB. Equivalent 10-year angiographic and long-term clinical outcomes with saphenous vein composite grafts and arterial composite grafts. // J Thorac Cardiovasc Surg. 2021;162(5):1535-43.e4. doi:10.1016/j.
7. Samano N, Geijer H, Liden M, et al. The no-touch saphenous vein for coronary artery bypass grafting maintains a patency, after 16 years, comparable to the left internal thoracic artery: A randomized trial. J Thorac Cardiovasc Surg 2015;150:880-8. DOI: 10.1016/j.jtcvs.2015.07.027.
8. Royse AG, Bellomo R, Royse CF, Clarke-Errey S, Boggett S, Kelly T, et al. Radial artery vs bilateral mammary composite Y coronary artery grafting: 15-year outcomes. // Ann Thorac Surg. 2021;111(6):1945-53. doi:10.1016/j.athoracsur.2020.08.019
9. Sohn SH, Lee Y, Choi JW, Hwang HY, Kim KB. Bilateral internal thoracic artery in situ versus Y-composite graftings: long-term outcomes. // Ann Thorac Surg. 2020;109(6):1773-80. doi:10.1016/j.athoracsur.2019.09.057.
10. Kim MS, Hwang HY, Cho KR, Kim KB. Right gastroepiploic artery versus right internal thoracic artery composite grafts: 10-year patency and long-term outcomes. // J Thorac Cardiovasc Surg. 2022;163(4):1333- 43.e1. doi:10.1016/j.jtcvs.2020.05.096.
Review
For citations:
Schneider Y.A., Tsoi V.G., Fomenko M.S., Pavlov A.A., Shilenko P.A. T-graft (Saphenous Vein to LIMA) in Minimally Invasive Coronary Artery Bypass Grafting in Patients with Coronary Artery Disease. Minimally Invasive Cardiovascular Surgery. 2023;2(2):18-24. (In Russ.)
Views:
244
Email this article 