Introduction
The saphenous vein (SV) is still the most commonly used secondary conduit for myocardial revascularization even though it has disadvantages of declining patency with time and resultant worse clinical outcomes compared with patency and outcomes of the internal thoracic artery (ITA) conduit [1]. Of numerous efforts to overcome the structural and functional limitations of SV conduit, the “no-touch” SV (NT SV) harvesting technique with or without a surrounding pedicle tissue and the surgical strategy of using the NT SV as part of a composite graft based on the left ITA have demonstrated good SV conduit patency rates comparable to arterial conduit patency rates [2-4]. Another recent study from our group demonstrated that NT SV conduits harvested with pedicle tissue further improved the early and 1-year patency of SV composite grafts, compared with NT SV conduits harvested without pedicle tissue [5]. When investigating the serial angiograms of NT SV composite grafts, we observed reopening cases of previously occluded NT SV conduits that were not reported in the literature.
The aims of the present study were (1) to assess the occlusion rates of NT SV composite grafts as seen in early postoperative angiograms; (2) to re-evaluate the occluded NT SV composite grafts by 1-year postoperative angiography; and (3) to elucidate the mechanism of NT SV composite graft reopening found during 1-year follow-up.