New method resulted in healthier coronary artery bypass grafts

In his PhD research, Øystein Pettersen has looked at short-term effects of pedicled vein grafts in coronary surgery.


MAIN RESULTS:

  1. Pedicled vein grafts reduces intimal hyperplasia following coronary artery bypass grafting.
  2. Pedicled vein harvesting does not increase bleeding or complications at the harvesting site.
  3. The imaging technique optical coherence tomography shows atherosclerosis in vein grafts with good reproducibility.

THESIS DEFENCE:

Thesis: Pedicled Veins in Coronary Surgery: Early Results from a Randomized Clinical Trial
Candidate: Øystein Pettersen
Time: May 31, 2019 at 12:15
Place: St. Olavs Hospital, Medical Technical Research Center: Auditorium MTA
Link to university website (in Norwegian)


SUMMARY:

Pettersen has performed a randomized controlled trial on 100 patients undergoing coronary artery bypass grafting (CABG) at St. Olavs Hospital. In half of the patients a pedicled technique was used to harvest the vein used as the graft, whereas the rest of the patients received conventional vein harvesting. With the pedicled technique, perivascular tissue is included when the vein is harvested.

(1) Intimal hyperplasia was significantly lower after six months in patients treated with pedicled veins. The variability of the thickness of the intima was also lower compared to those treated with the conventional method. The short-term follow-up did not show any significant difference in the number of totally occluded veins, but a five year follow-up study is planned to assess that question.

(2) The technique with pedicled veins is a little more time-consuming than conventional vein harvesting, but did not increase leg bleeding or infections at the harvesting site.

(3) Pettersen and co-workers used the high-resolution imaging technique optical coherence tomography to evaluate intimal hyperplasia in their study. The third article of the thesis shows that this technique has high reproducibility both when used several times by the same investigator and when used by different investigators.


REFERENCES:

(1) Pettersen, Ø., Wiseth, R., Hegbom, K., & Nordhaug, D. O. (2016). Pedicled vein grafts in coronary surgery exhibit reduced intimal hyperplasia at 6 monthsJournal of the American College of Cardiology68(4), 427-429.

(2) Pettersen, Ø., Haram, P. M., Winnerkvist, A., Karevold, A., Wahba, A., Stenvik, M., … & Nordhaug, D. O. (2017). Pedicled vein grafts in coronary surgery: perioperative data from a randomized trialThe Annals of thoracic surgery104(4), 1313-1317.

(3) Pettersen, Ø., Pociask, E., Malinowski, K. P., Slezak, M., Hegbom, K., Wiseth, R., & Nordhaug, D. O. (2018). Reproducibility of optical coherence tomography in vein grafts used for coronary revascularizationCardiology journal.