Impact of endoscopic versus open saphenous vein harvest technique on late coronary artery bypass grafting patient outcomes in the ROOBY (Randomized On/Off Bypass) Trial.

In the Randomized On/Off Bypass (ROOBY) Trial, the efficacy of on-pump versus off-pump coronary artery bypass grafting was evaluated. This ROOBY Trial planned subanalysis compared the effects on postbypass patient clinical outcomes and graft patency of endoscopic vein harvesting and open vein harvesting. From April 2003 to April 2007, the technique used for saphenous vein graft harvesting was recorded in 1471 cases. Of these, 894 patients (341 endoscopic harvest and 553 open harvest) also underwent coronary angiography 1 year after coronary artery bypass grafting. Univariate and multivariable analyses were used to compare patient outcomes in the endoscopic and open groups. Preoperative patient characteristics were statistically similar between the endoscopic and open groups. Endoscopic vein harvest was used in 38% of the cases. There were no significant differences in both short-term and 1-year composite outcomes between the endoscopic and open groups. For patients with 1-year catheterization follow-up (n=894), the saphenous vein graft patency rate for the endoscopic group was lower than that in the open harvest group (74.5% vs 85.2%, P<.0001), and the repeat revascularization rate was significantly higher (6.7% vs 3.4%, P<.05). Multivariable regression documented no interaction effect between endoscopic approach and off-pump treatment. In the ROOBY Trial, endoscopic vein harvest was associated with lower 1-year saphenous vein graft patency and higher 1-year revascularization rates, independent of the use of off-pump or on-pump cardiac surgical approach.

Zenati MA ，Shroyer AL ，Collins JF ，Hattler B ，Ota T ，Almassi GH ，Amidi M ，Novitzky D ，Grover FL ，Sonel AF ... -  《-》

Randomized trial of endoscopic versus open vein harvest for coronary artery bypass grafting: six-month patency rates.

Yun KL ，Wu Y ，Aharonian V ，Mansukhani P ，Pfeffer TA ，Sintek CF ，Kochamba GS ，Grunkemeier G ，Khonsari S ... -  《JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY》

A randomized comparison of the Saphenous Vein Versus Right Internal Thoracic Artery as a Y-Composite Graft (SAVE RITA) trial: early results.

The Saphenous Vein Versus Right Internal Thoracic Artery as a Y-Composite Graft trial was designed to evaluate the saphenous vein compared with the right internal thoracic artery as a Y-composite graft anastomosed to the side of the left internal thoracic artery. In this early analysis, we compared early angiographic patency rates and clinical outcomes. From September 2008 to October 2011, 224 patients with multivessel coronary artery disease were randomized prospectively to undergo off-pump revascularization using the saphenous vein group (n = 112) or the right internal thoracic artery group (n = 112) as Y-composite grafts. Early postoperative (1.4 ± 1.1 days) angiographic patency and clinical outcomes were compared. There was 1 operative death in the right internal thoracic artery group. No statistically significant differences in postoperative morbidities, including atrial fibrillation and acute renal failure, were observed between the groups. The number of distal anastomoses using the side-arm Y-composite graft (saphenous vein vs right internal thoracic artery) were 2.3 ± 0.8 and 1.9 ± 0.7 in the saphenous vein and right internal thoracic artery groups, respectively (P < .001). A third conduit was used in 44 patients (saphenous vein group vs right internal thoracic artery group, 4/109 vs 40/110; P < .001) to extend the side-arm Y-composite graft for complete revascularization. Early angiography demonstrated an overall patency rate of 99.4% (771 of 776 distal anastomoses). Patency rates of the side-arm Y-composite graft (saphenous vein vs right internal thoracic artery) were 98.8% (245 of 248) and 99.5% (207 of 208) in the saphenous vein and right internal thoracic artery groups, respectively (P = .629). A third conduit was needed to extend the right internal thoracic artery composite graft and reach the target vessels in 36.4% (40/110) of the patients. The saphenous vein composite graft was comparable with the right internal thoracic artery composite graft in terms of early angiographic patency and clinical outcomes.

Hwang HY ，Kim JS ，Oh SJ ，Kim KB ... -  《-》

Off-Pump coronary artery bypass surgery is associated with worse arterial and saphenous vein graft patency and less effective revascularization: Results from the Veterans Affairs Randomized On/Off Bypass (ROOBY) trial.

Hattler B ，Messenger JC ，Shroyer AL ，Collins JF ，Haugen SJ ，Garcia JA ，Baltz JH ，Cleveland JC Jr ，Novitzky D ，Grover FL ，Veterans Affairs Randomized On/Off Bypass (ROOBY) Study Group ... -  《-》

Endoscopic versus direct vision for saphenous vein graft harvesting in coronary artery bypass surgery.

Ad N ，Henry L ，Hunt S ，Holmes S ，Burton N ，Massimiano P ，Rhee J ，Rongione A ，Speir A ，Collazo L ... -  《-》