Five-year Patency of No-touch Saphenous Vein Grafts in On-pump Versus Clamp-less Off-pump Coronary Artery Bypass Surgery

Inclusion criteria

• Patients were eligible if they:

• provided written informed consent;
• were >21 years of age;
• required isolated CABG with median sternotomy;
• had at least one of the following risk factors:

• had peripheral vascular disease (previous peripheral bypass, amputation or anklebranchial index <0.90),
• had cerebrovascular disease (history of stroke, transient ischemic attach or carotid stenosis ≥70%),
• had renal insufficiency (creatinine above upper limit of normal),
• were ≥70 years of age, or
• were between the ages of 60-69 with one of the following: i. had diabetes and taking an oral hypoglycemic agent and/or insulin, ii. required urgent revascularization (i.e., waiting in hospital for revascularization after an acute coronary syndrome), iii. were a recent smoker (within 1 year of randomization), or iv. had left ventricular ejection fraction ≤35%, OR
• were between the ages of 55-59 with two of the following: i. Diabetes and taking an oral hypoglycemic agent and/or insulin, ii. required urgent revascularization (i.e., waiting in hospital for revascularization after an acute coronary syndrome, iii. were a recent smoker (within 1 year of randomization), or iv. had a left ventricular ejection fraction ≤35%

Exclusion criteria

• Patients were excluded if they:

• required a concomitant cardiac procedure associated with CABG;
• had a contraindication to off-pump or on-pump CABG (e.g., calcified aorta, intramuscular left anterior descending artery, calcified coronaries, small target vessels);
• had a concomitant life-threatening disease likely to limit life expectancy to less than 2 years;
• were previously enrollment in the CORONARY Trial;
• required emergency CABG surgery (i.e., immediate revascularization for hemodynamic instability); OR
• required a redo CABG.