Samano Ninos, Souza Domingos, Pinheiro Bruno Botelho, Kopjar Tomislav, Dashwood Michael
Örebro University Faculty of Medicine and Health Örebro Sweden Department of Cardiothoracic and Vascular Surgery and University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Örebro University Faculty of Medicine and Health Department of Cardiothoracic and Vascular Surgery Örebro Sweden Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Braz J Cardiovasc Surg. 2020 Feb 1;35(1):91-99. doi: 10.21470/1678-9741-2019-0238.
The saphenous vein is the most common conduit used in coronary artery bypass grafting (CABG) yet its failure rate is higher compared to arterial grafts. An improvement in saphenous vein graft performance is therefore a major priority in CABG. No-touch harvesting of the saphenous vein is one of the few interventions that has shown improved patency rates, comparable to that of the left internal thoracic artery. After more than two decades of no-touch research, this technique is now recognized as a Class IIa recommendation in the 2018 European Society of Cardiology and the European Association for Cardio-Thoracic Surgery guidelines on myocardial revascularization. In this review, we describe the structural alterations that occur in conventional versus no-touch saphenous vein grafts and how these changes affect graft patency. In addition, we discuss various strategies aimed at repairing saphenous vein grafts prepared at conventional CABG.
大隐静脉是冠状动脉旁路移植术（CABG）中最常用的血管 conduit，但与动脉移植物相比，其失败率更高。因此，提高大隐静脉移植物的性能是CABG的一个主要优先事项。大隐静脉的非接触式采集是少数已显示出通畅率提高的干预措施之一，与左胸廓内动脉相当。经过二十多年的非接触式研究，该技术现在在2018年欧洲心脏病学会和欧洲心胸外科学会关于心肌血运重建的指南中被列为IIa类推荐。在本综述中，我们描述了传统与非接触式大隐静脉移植物中发生的结构改变，以及这些变化如何影响移植物通畅率。此外，我们还讨论了旨在修复传统CABG中制备的大隐静脉移植物的各种策略。
