No-touch saphenous vein as an important conduit of choice in coronary bypass surgery

Coronary heart disease is a major cause of death and disability in developed countries. Coronary artery bypass grafting (CABG) remains the most effective way of treatment for patients with advanced disease (1). Approximately one million people undergo CABG annually worldwide, depicting the epidemiologic impact of the procedure and its influence on public health. Continuous efforts are employed to optimize the procedure of CABG. Long-term results depend highly on the appropriate conduit choice for bypass. Several groups support the use of multiple arterial grafts for improving long-term outcomes. Others claim a lack of unequivocal evidence that this strategy is associated with better clinical outcome and higher patency rates. The most widespread combination of grafts for CABG remains the left internal thoracic artery to the left anterior descending coronary artery supplemented with multiple venous grafts for remaining territories (2). However, relative to arterial grafts, saphenous vein graft failure rates were reported high, at up to 25% in the first 18 months (3)