Saphenous Vein as Y-composite Versus Aortocoronary Conduit for CABG

Left internal thoracic artery (LITA) has been acknowledged as the first graft of choice for coronary artery bypass grafting (CABG). However, it is still not conclusive which one is the best second graft of choice among right internal thoracic artery, radial artery, right gastroepiploic artery, saphenous vein, and etc., as well as its configuration for CABG.In our institution, saphenous vein has been primarily used for the second graft and we have harvested it with 'No touch technique'. We have been demonstrated the excellent long-term patency of this 'No touch saphenous vein' in many studies. However, it is still unknown which configuration is the better strategy for the saphenous vein as a Y-composite graft based on the left internal thoracic artery versus an aortocoronary conduit. Thus, we aimed to evaluate morphologic change of saphenous vein graft by 1-year intravascular ultrasound (IVUS) study and angiographic patency results between Y-composite graft and aortocoronary conduit.

Inclusion Criteria:A patient who is going to receive coronary artery bypass graftingOlder than 19 yearsCoronary artery bypass grafting is going to be performed with left internal thoracic artery and saphenous vein graftExclusion Criteria:Other concomitant procedures (e.g. valve or aorta surgery) is plannedPatients with severe comorbidities which limit the life expectancy of them below 1 year (e.g. terminal cancer)Patients whose left internal thoracic artery or saphenous vein is not available due to the low quality, severe injury, or absence of the graftPatients whose ascending aorta is not suitable to aortocoronary anastomosis (e.g. ascending aorta aneurysm, porcelain aorta)Emergency operationPatients who have connective tissue diseaseReoperative coronary artery bypass grafting