• Ho Young Hwang, Yeiwon Lee, Suk Ho Sohn, Jae Woong Choi, and Ki-Bong Kim.
• Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea.
• J. Thorac. Cardiovasc. Surg. 2021 Nov 1; 162 (5): 1535-1543.e4.

ObjectivesWe compared 10-year graft patency rates and long-term clinical outcomes after off-pump coronary artery bypass grafting using the saphenous vein composite grafts based on the left internal thoracic artery with those using total arterial composite grafts.MethodsA total of 483 patients who underwent off-pump coronary artery bypass grafting using composite grafts based on the left internal thoracic artery were included. The saphenous vein was used as a second (connected to the left internal thoracic artery; n = 63) or a third (connected to the second arterial graft; n = 40) composite graft in 103 patients (SV group); total arterial composite grafting was performed in 380 patients (ART group). A propensity score-matched analysis was used to match the SV group to the ART group (n = 103 patients in each). The median follow-up duration was 128 (97-139) months.ResultsThere were no differences in operative mortality and postoperative complication rates between the 2 matched groups. Propensity score-matched analyses showed no differences in the overall survival and freedom from cardiac death rates between the 2 groups (P = .369 and P = .206, respectively) up to 12 years after surgery. Freedom rates from reintervention and major adverse cardiac and cerebrovascular events were also similar between the 2 matched groups (P = .695 and P = .758, respectively) up to 12 years after surgery. Generalized mixed-effects models showed that the 2 matched groups demonstrated no differences in overall and composite graft patency rates during 10 years after surgery (P = .568 and P = .702, respectively).ConclusionsThe saphenous vein composite grafts were equivalent to arterial composite grafts in terms of 10-year graft patency and long-term clinical outcomes.Copyright © 2020 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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