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  1. Article ; Online: Five-Year Follow-Up After Transcatheter Aortic Valve Implantation in Patients with Severe Aortic Stenosis and Concomitant Coronary Artery Disease: A Single-Center Experience.

    Abawi, Akram / Magnuson, Anders / Fröbert, Ole / Samano, Ninos

    Brazilian journal of cardiovascular surgery

    2023  Volume 39, Issue 1, Page(s) e20220461

    Abstract: Introduction: There is no consensus on the impact of coronary artery disease in patients undergoing transcatheter aortic valve implantation. Therefore, the objective of this study was, in a single-center setting, to evaluate the five-year outcome of ... ...

    Abstract Introduction: There is no consensus on the impact of coronary artery disease in patients undergoing transcatheter aortic valve implantation. Therefore, the objective of this study was, in a single-center setting, to evaluate the five-year outcome of transcatheter aortic valve implantation patients with or without coronary artery disease.
    Methods: All transcatheter aortic valve implantation patients between 2009 and 2019 were included and grouped according to the presence or absence of coronary artery disease. The primary endpoint, five-year all-cause mortality, was evaluated using Cox regression adjusted for age, sex, procedure years, and comorbidities. Comorbidities interacting with coronary artery disease were evaluated with interaction tests. In-hospital complications was the secondary endpoint.
    Results: In total, 176 patients had aortic stenosis and concomitant coronary artery disease, while 170 patients had aortic stenosis only. Mean follow-up was 2.2±1.6 years. There was no difference in the adjusted five-year all-cause mortality between transcatheter aortic valve implantation patients with and without coronary artery disease (hazard ratio 1.00, 95% confidence interval 0.59-1.70, P=0.99). In coronary artery disease patients, impaired renal function, peripheral arterial disease, or ejection fraction < 50% showed a significant interaction effect with higher five-year all-cause mortality. No significant differences in complications between the groups were found.
    Conclusion: Five-year mortality did not differ between transcatheter aortic valve implantation patients with or without coronary artery disease. However, in patients with coronary artery disease and impaired renal function, peripheral arterial disease, or ejection fraction < 50%, we found significantly higher five-year all-cause mortality.
    MeSH term(s) Humans ; Coronary Artery Disease/complications ; Coronary Artery Disease/surgery ; Transcatheter Aortic Valve Replacement/methods ; Follow-Up Studies ; Treatment Outcome ; Aortic Valve Stenosis/complications ; Aortic Valve Stenosis/surgery ; Peripheral Arterial Disease/complications ; Aortic Valve/surgery ; Risk Factors
    Language English
    Publishing date 2023-10-27
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 2031026-2
    ISSN 1678-9741 ; 1678-9741
    ISSN (online) 1678-9741
    ISSN 1678-9741
    DOI 10.21470/1678-9741-2022-0461
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Saphenous vein harvesting for CABG: wear a VEST or keep the fat?

    Dashwood, Michael R / Samano, Ninos / Souza, Domingos S

    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

    2022  Volume 62, Issue 1

    MeSH term(s) Coronary Artery Bypass/adverse effects ; Humans ; Saphenous Vein ; Tissue and Organ Harvesting
    Language English
    Publishing date 2022-06-16
    Publishing country Germany
    Document type Letter ; Comment
    ZDB-ID 639293-3
    ISSN 1873-734X ; 1010-7940 ; 1567-4258
    ISSN (online) 1873-734X
    ISSN 1010-7940 ; 1567-4258
    DOI 10.1093/ejcts/ezac349
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Reply: No-touch saphenous veins and radial arteries should qualify for the same coronary artery bypass grafting team.

    Souza, Domingos / Samano, Ninos

    The Journal of thoracic and cardiovascular surgery

    2020  Volume 159, Issue 6, Page(s) e337–e338

    MeSH term(s) Awards and Prizes ; Coronary Artery Bypass ; Mammary Arteries ; Radial Artery ; Saphenous Vein
    Language English
    Publishing date 2020-03-17
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2020.02.071
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: What is the impact of preserving the endothelium on saphenous vein graft performance? Comments on the 'NO' touch harvesting technique.

    Samano, Ninos / Loesch, Andrzej / Dashwood, Michael R

    Journal of cardiothoracic surgery

    2021  Volume 16, Issue 1, Page(s) 21

    Abstract: Saphenous veins used for coronary artery bypass surgery are subjected to considerable vascular trauma when harvested by conventional methods. This vascular damage is responsible, at least in part, for the inferior patency of the saphenous vein when ... ...

    Abstract Saphenous veins used for coronary artery bypass surgery are subjected to considerable vascular trauma when harvested by conventional methods. This vascular damage is responsible, at least in part, for the inferior patency of the saphenous vein when compared with the internal thoracic artery. The performance of saphenous vein grafts is improved when this conduit is harvested atraumatically using the no-touch technique. There is growing evidence that the success of the no-touch technique is due to the preservation of a number of vascular structures including the endothelium, vasa vasorum and perivascular fat. There is conflicting evidence regarding the degree of endothelial damage to the endothelium of conventional versus no-touch saphenous vein grafts. In general, it has been shown that this single layer of cells lining the lumen exhibits considerable damage associated with a combination of vascular trauma and high pressure intraluminal distension. Increased platelet aggregation and thrombus formation at the exposed subendothelial membrane is due to a local reduction of endothelium-derived factors including nitric oxide. In addition, damage to the vasa vasorum of conventionally-harvested veins will reduce transmural blood flow, a condition shown to promote neointimal hyperplasia and atheroma formation. By stripping off the perivascular fat during conventional harvesting, mechanical support of the graft is reduced and the source of adipocyte-derived factors potentially beneficial for graft patency removed. While most agree that endothelial damage to the saphenous vein affects graft patency, the contribution of other tissue-derived factors affected by vascular damage at harvesting need to be considered.
    MeSH term(s) Coronary Artery Bypass/methods ; Coronary Artery Disease/surgery ; Endothelium, Vascular ; Humans ; Nitric Oxide/pharmacology ; Saphenous Vein/physiology ; Saphenous Vein/transplantation ; Tissue and Organ Harvesting/methods ; Vascular Patency/physiology
    Chemical Substances Nitric Oxide (31C4KY9ESH)
    Language English
    Publishing date 2021-03-16
    Publishing country England
    Document type Letter
    ISSN 1749-8090
    ISSN (online) 1749-8090
    DOI 10.1186/s13019-021-01397-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Long-term results of percutaneous coronary intervention in no-touch vein grafts are significantly better than in conventional vein grafts.

    Ferrari, Gabriele / Geijer, Håkan / Cao, Yang / Graf, Ulf / Bojö, Leif / Carlsson, Roland / Souza, Domingos / Samano, Ninos

    Perfusion

    2024  , Page(s) 2676591241230012

    Abstract: Introduction: Conventional vein grafts have a high risk of thrombosis and early atherosclerosis. Percutaneous coronary intervention (PCI) in conventional vein grafts is associated with a higher incidence of late adverse cardiac events. The aim of this ... ...

    Abstract Introduction: Conventional vein grafts have a high risk of thrombosis and early atherosclerosis. Percutaneous coronary intervention (PCI) in conventional vein grafts is associated with a higher incidence of late adverse cardiac events. The aim of this study was to evaluate the long-term results after PCI in saphenous vein grafts (SVG) harvested with the no-touch technique compared to the conventional technique.
    Methods: This was a single-center, retrospective, cohort study, based on data from the Swedeheart register. The inclusion criterion was individuals who underwent CABG using different vein graft techniques between January 1992 and July 2020, and who required a PCI in SVGs between January 2006 and July 2020. The primary end point was long-term in-stent restenosis. The secondary endpoints were long-term major adverse cardiac events (MACE) and 1-year re-hospitalization rates. The associations between the graft types and the endpoints were evaluated using the Fine and Gray competing-risk regression analysis.
    Results: The study included 346 individuals (67 no-touch, 279 conventional). The mean clinical follow-up time was 6.4 years with a standard deviation of 3.7 years. The long-term in-stent restenosis rate for the no-touch grafts was 3.2% compared to 18.7% for the conventional grafts (
    Conclusions: Percutaneous coronary intervention in a no-touch vein graft was associated with statistically significantly fewer in-stent restenoses and MACE at long-term follow-up compared to a conventional SVG.
    Language English
    Publishing date 2024-01-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 645038-6
    ISSN 1477-111X ; 0267-6591
    ISSN (online) 1477-111X
    ISSN 0267-6591
    DOI 10.1177/02676591241230012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Saphenous veins in coronary artery bypass grafting need external support.

    Samano, Ninos / Souza, Domingos / Dashwood, Michael R

    Asian cardiovascular & thoracic annals

    2020  Volume 29, Issue 5, Page(s) 457–467

    Abstract: The saphenous vein is the most commonly used conduit for coronary artery bypass grafting. Arterial grafts are harvested with the outer pedicle intact whereas saphenous veins are harvested with the pedicle removed in the conventional graft harvesting ... ...

    Abstract The saphenous vein is the most commonly used conduit for coronary artery bypass grafting. Arterial grafts are harvested with the outer pedicle intact whereas saphenous veins are harvested with the pedicle removed in the conventional graft harvesting technique. This conventional procedure causes considerable vascular damage. One strategy to improve vein graft patency has been to provide external support. Ongoing studies show that fitting a metal external support improves conventionally harvested saphenous vein graft patency. On the other hand, the no-touch technique of harvesting the saphenous vein provides an improved graft with long-term patency comparable to that of the internal mammary artery. This improvement is suggested to be due to preservation of vessel structures. Interestingly, many of the mechanisms proposed to be associated with the beneficial actions of an artificial external support on saphenous vein graft patency are similar to those underlying the beneficial effect of no-touch saphenous vein grafts where the intact outer layer acts as a natural support. Additional actions of external supports have been advocated, including promotion of angiogenesis, increased production of vascular-protective factors, and protection of endothelial cells. Using no-touch harvesting, normal vascular architecture is maintained, tissue and cell damage is minimized, and factors beneficial for graft patency are preserved. In this review, the significance of external support of saphenous vein grafts in coronary artery bypass grafting is discussed.
    MeSH term(s) Coronary Artery Bypass/adverse effects ; Endothelial Cells ; Humans ; Mammary Arteries ; Saphenous Vein ; Vascular Patency
    Language English
    Publishing date 2020-12-13
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1400468-9
    ISSN 1816-5370 ; 0218-4923
    ISSN (online) 1816-5370
    ISSN 0218-4923
    DOI 10.1177/0218492320980936
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Percutaneous coronary intervention in saphenous vein grafts after coronary artery bypass grafting: a systematic review and meta-analysis.

    Ferrari, Gabriele / Geijer, Håkan / Cao, Yang / Souza, Domingos / Samano, Ninos

    Scandinavian cardiovascular journal : SCJ

    2021  Volume 55, Issue 4, Page(s) 245–253

    Abstract: To investigate the results of percutaneous coronary intervention (PCI) in saphenous vein grafts after coronary artery bypass grafting (CABG). ...

    Abstract To investigate the results of percutaneous coronary intervention (PCI) in saphenous vein grafts after coronary artery bypass grafting (CABG).
    MeSH term(s) Coronary Artery Bypass ; Coronary Restenosis/etiology ; Humans ; Percutaneous Coronary Intervention/adverse effects ; Saphenous Vein/surgery
    Language English
    Publishing date 2021-03-18
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 1379906-x
    ISSN 1651-2006 ; 1401-7431
    ISSN (online) 1651-2006
    ISSN 1401-7431
    DOI 10.1080/14017431.2021.1900598
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  8. Article ; Online: Quality of Life After Percutaneous Coronary Intervention in No-Touch Saphenous Vein Grafts is Significantly Better Than in Conventional Vein Grafts.

    Ferrari, Gabriele / Karlsson, Jan / Cao, Yang / Geijer, Håkan / Souza, Domingos / Samano, Ninos

    Brazilian journal of cardiovascular surgery

    2022  Volume 37, Issue 4, Page(s) 430–438

    Abstract: Objective: To compare health-related quality of life (HRQoL) of patients primarily treated with a no-touch saphenous vein graft with that of patients who received a conventional graft.: Methods: The study included all individuals treated with a ... ...

    Abstract Objective: To compare health-related quality of life (HRQoL) of patients primarily treated with a no-touch saphenous vein graft with that of patients who received a conventional graft.
    Methods: The study included all individuals treated with a percutaneous coronary intervention (PCI) on a saphenous vein graft (SVG) between January 2006 and June 2020. The RAND-36 health survey was used to assess HRQoL. The Mann-Whitney U test was used to test differences in HRQoL between the two groups. Effect size was estimated via Cohen's d. The average treatment effect between the groups was tested by propensity score matching (PSM).
    Results: Of the 346 patients treated with a PCI in a stenosed or occluded SVG, 165 responded to RAND-36 (no-touch: n=48; conventional: n=117). Patients with a no-touch graft reported better mean values on seven of the eight health survey domains. Statistically significant differences were observed for four of the domains, all in favour of the no-touch group. The effect size estimates indicated a small difference for five domains, with the highest values (>0.40) seen for the general health and energy/fatigue domains. PSM confirmed a statistically significant difference for the physical functioning and general health domains.
    Conclusion: At a mean follow-up of 5.4 years, patients who received a PCI in no-touch vein grafts showed significantly better HRQoL than those who received a PCI in conventional vein grafts.
    MeSH term(s) Coronary Artery Bypass/adverse effects ; Humans ; Percutaneous Coronary Intervention/adverse effects ; Quality of Life ; Saphenous Vein/transplantation ; Treatment Outcome
    Language English
    Publishing date 2022-08-16
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 2183753-3
    ISSN 1678-9741 ; 1678-9741
    ISSN (online) 1678-9741
    ISSN 1678-9741
    DOI 10.21470/1678-9741-2021-0576
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Surgical Aspects of No-Touch Saphenous Vein Graft Harvesting in CABG: Clinical and Angiographic Follow-Up at 3 Months.

    Samano, Ninos / Pinheiro, Bruno Botelho / Souza, Domingos

    Brazilian journal of cardiovascular surgery

    2019  Volume 34, Issue 1, Page(s) 98–100

    Abstract: With more than 800,000 coronary artery bypass grafting (CABG) operations annually worldwide and the saphenous vein being the most common conduit used, there is no question that improving saphenous vein graft patency is one of the most important tasks in ... ...

    Abstract With more than 800,000 coronary artery bypass grafting (CABG) operations annually worldwide and the saphenous vein being the most common conduit used, there is no question that improving saphenous vein graft patency is one of the most important tasks in CABG. This video describes the no-touch harvesting procedure of the saphenous vein on an 80-year old man with hypertension, hyperlipidemia and a previous myocardial infarction with percutaneous coronary intervention to the right coronary artery. He was complaining of exertional chest pain and was diagnosed with stable angina pectoris. The coronary angiography showed advanced three vessel disease with significant stenoses in the left anterior descending (LAD) artery, two marginal arteries (MAs) and the posterior descending artery (PDA), in addition to an occluded diagonal artery (DA). The patient received a triple sequential no-touch vein graft to the PDA and two MAs together with a double sequential no-touch vein graft to the DA and LAD. A vein graft was used to bypass the LAD due to the age of the patient and the low degree of stenosis in the LAD. The no-touch harvesting technique is described in detail in the film with complete narration. A follow-up of this patient was performed at three months both clinically and with a computed tomography angiography (CTA). No angina pectoris symptoms were reported by the patient and the wounds in the chest and lower limb were completely healed. The CTA showed patent no-touch saphenous vein grafts to all the distal anastomoses.
    MeSH term(s) Aged, 80 and over ; Computed Tomography Angiography/methods ; Coronary Angiography/methods ; Coronary Artery Bypass/methods ; Coronary Artery Disease/surgery ; Coronary Stenosis/surgery ; Humans ; Male ; Reproducibility of Results ; Saphenous Vein/transplantation ; Treatment Outcome
    Language English
    Publishing date 2019-02-21
    Publishing country Brazil
    Document type Case Reports ; Journal Article ; Video-Audio Media
    ZDB-ID 2031026-2
    ISSN 1678-9741 ; 0102-7638
    ISSN (online) 1678-9741
    ISSN 0102-7638
    DOI 10.21470/1678-9741-2018-0352
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Long-term patency versus leg wound healing in coronary artery bypass surgery: Surgical aspects of the no-touch harvesting technique.

    Souza, Domingos / Samano, Ninos

    The Journal of thoracic and cardiovascular surgery

    2016  Volume 151, Issue 1, Page(s) 276

    MeSH term(s) Female ; Humans ; Male ; Mammary Arteries/transplantation ; Saphenous Vein/transplantation
    Language English
    Publishing date 2016-01
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2015.10.025
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