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The small saphenous vein as an alternative conduit for coronary artery bypass grafting

Bursa Yüksek Ihtisas Education and Research Hospital, Bursa 16330, Turkey

What is the patency of the short saphenous vein when used for coronary artery bypass grafting?

I read with much interest the article by Jacob et al. [1] about the patency of the small saphenous vein (SSV) (also short saphenous vein) as an alternative conduit for coronary artery bypass grafting (CABG). I congratulate the authors for their effort in developing this very important meta-analysis. I would also like to share additional comments on this topic.

Currently, cardiovascular surgeons have been challenged by ever-increasing numbers of patients with poor quality, or deficient quantity, of conduit available for CABG. As a result, alternative conduits and/or methods to provide a safe and effective CABG have been put into practice.

SSV is an alternative conduit in patients with unsuitable arterial and insufficient venous grafts for CABG. SSV may be harvested with supine position of the patient on the table, which is adduction and internal rotation at the hip level and flexion at the knee level.

The outcome of CABG with SSV graft is unsatisfactory because venous grafts are prone to occlusive disease. Occlusion rate of venous grafts is around 12–20% during the 1st year and 2–4% annually for the next 4 or 5 years [2].

As described by the authors, long-term angiographic follow-up of the patency of SSV grafts is not sufficient and there are trials with a small number of patients. In our clinic, we used SSV in three patients due to insufficient venous graft for the last five years. The patients were clinically asymptomatic at follow-up but there still have been no angiographic findings, which support this clinical status.

Finally, the strategy of CABG must be based on the fact that sufficient conduit should be available prior to sternotomy.

	References

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1. Jacob S, Kallikourdis A, El-Shafei H, Dunning J. What is the patency of the short saphenous vein when used for coronary artery bypass grafting? Interact CardioVasc Thorac Surg 2007; 6:783–786.[Abstract/Free Full Text]
2. Grondin CM, Campeau L, Thornton JC, Engle JC, Cross FS, Schreiber H. Coronary artery bypass grafting with saphenous vein. Circulation 1989; 79:I24–I29.[Medline]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Senol Yavuz Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Yavuz, S. Search for Related Content PubMed PubMed Citation Articles by Yavuz, S. Related Collections Related Article