External stenting of vein grafts has been shown to reduce graft disease by mitigating intimal hyperplasia and improving flow pattern in on-pump single vein graft context. Aim of study is to evaluate usability and clinical outcome of external stenting also in patients undergoing beating-heart sequential grafting receiving multiple external stents per patient.
Thirty patients undergoing CABG had the venous grafts supported with VEST (VascularGraftSolutions, Israel) and were prospectively followed-up via phone call and/or visit every 6 months. Major Adverse Cardiac and Cerebrovascular Events (MACCE) were recorded. Planned follow-up is 5 years.
Mean age was 69.0, 86.7% were males, mean Euroscore and ejection fraction were 5.40% ± 4.92% and 56.8% ± 7.4. Veins were harvested in an open manner. Average number of grafts per patient was 3.2. Each patient had either single vein graft (n = 20), or sequential vein grafts (n = 10) supported with VEST. All patients were discharged alive from the hospital after surgery. One patient experienced transient ischemic attack during in-hospital stay and fully recovered before discharge.
Follow up was complete for all patients, mean follow time of 16 months (range 1–31 months). During the follow up period, MACCE rate were 0% and no additional adverse events were reported. CT angiography performed to patients arriving at 1 year follow-up confirmed all grafts were patent.
External stenting of saphenous vein grafts is technically feasible in off pump CABG procedures and sequential grafting. Intermediate follow up of up to 30 months suggest that it's safe and not associated with major clinical events.
1Department of Heart Surgery - European Hospital Roma
2Department of Heart Surgery - European Hospital Rome