The no-touch vein graft for coronary artery bypass surgery preserves the left ventricular ejection fraction at 16 years postoperatively: long-term data from a longitudinal randomised trial

Benny Johansson, Ninos Samano, Domingos Souza, Lennart Bodin, Derek Filbey, John D Mannion, Leif Bojö, Benny Johansson, Ninos Samano, Domingos Souza, Lennart Bodin, Derek Filbey, John D Mannion, Leif Bojö

Abstract

Objectives: To assess the left ventricular heart function and the clinical outcome 16 years after coronary artery bypass surgery.

Design: In a randomised trial, the no-touch (NT) vein graft in coronary artery bypass surgery has shown a superior patency rate, a slower progression of atherosclerosis and better clinical outcome compared to the conventional (C) vein graft at 8.5 years. All patients at mean time 16 years were offered an echocardiographic and clinical examination.

Results: In the NT-group 34 patients and in the C-group 31 patients underwent an echocardiography examination. A significantly better left ventricle ejection fraction was seen in the NT-group compared to the C-group (57.9% vs 49.4%; p=0.011). The size of the left atrium in NT was 21.7 cm(2) compared to 23.9 cm(2) in C; p=0.034. No patient in NT had atrial fibrillation compared to five patients in C (p=0.021). Patients with a brain natriuretic peptide value (BNP) ≥150 was 30% in NT compared to 38% in C. Total mortality was 25% in NT vs 27% in C. Cardiac-related deaths were 8% and 12% in NT and C respectively.

Conclusions: The NT vein graft preserves the left ventricular ejection fraction after 16 years. A smaller left atrium, a lower BNP and no atrial fibrillation indicates an improved diastolic left ventricular function in the NT-group.

Trial registration: The study is registered with clinicaltrials.gov (NCT01686100) and The Research and Development registry in Sweden (no. 102841).

Keywords: Vein graft Disease.

Figures

Figure 1
Figure 1
Ejection fraction preoperatively and at follow-up in conventional (C) and no-touch (NT) groups. Statistical significance for difference between groups at 16-year follow-up, adjusted for prevalues, is shown by p1. Lines indicate gradient for ejection fraction from preoperation to 16-year follow-up and p2 shows statistical significance between groups with respect to gradient. Two hundred and eight observations on ejection fraction for 83 patients, number of observations for each assessment is shown in the figure.

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Source: PubMed

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