IN-HOSPITAL OUTCOMES OF MYOCARDIAL REVASCULARIZATION USING AN I-CONDUIT AND NO-TOUCH SAPHENOUS VEIN GRAFTING: RESULTS OF A RANDOMIZED CONTROLLED TRIAL

Highlights

● In this prospective randomized study (n = 106), no statistically significant differences were observed in the incidence of MACCE, in-hospital mortality, or conduit harvest-site complications between the I-graft and the free venous graft using the no-touch technique.

● The use of a no-touch saphenous vein conduit as part of an I-graft does not increase intraoperative risk or worsen early postoperative outcomes compared with a free venous graft configuration.

● The no-touch technique does not limit the choice of graft configuration and demonstrates comparable safety and reproducibility in the in-hospital period.

Aim. To evaluate in-hospital outcomes of myocardial revascularization using an I-conduit versus a no-touch saphenous vein graft in a randomized controlled trial.

Methods. This prospective randomized study included 106 patients with coronary artery disease who underwent coronary artery bypass grafting between January 2023 and December 2024. Patients were randomized using sealed envelopes into two groups: the first group underwent revascularization with a no-touch saphenous vein conduit configured as an I-composite graft (n = 53); the second group received revascularization with the same no-touch conduit but with a proximal anastomosis to the ascending aorta (n = 53). In-hospital outcomes included the incidence of major adverse cardiac and cerebrovascular events (MACCE), conduit harvest-site complications, and mortality.

Results. The groups were comparable in demographic, clinical, and surgical characteristics. No statistically significant differences were observed in the in-hospital incidence of MACCE (1.89% vs 0%; p > 0,99), mortality (1.89% vs 0%; p > 0.99), harvest-site complications (edema: 11.32% vs 16.98%; p = 0.58), or length of hospital stay (12.5 ± 9.2 vs 11.7 ± 4.0 days; p = 0.95).

Conclusion. This prospective randomized study demonstrated comparable safety and efficacy of the no-touch technique when used as an I-graft or as a free venous graft in coronary artery bypass surgery. No significant differences were found in MACCE, harvest-site complications, or in-hospital mortality. Both approaches showed similarly favorable early postoperative outcomes. Long-term advantages of the I-graft configuration require further investigation.

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