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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Case Series Analysis of No-Touch Graft Configurations in Coronary Artery Bypass Grafting: Comparative Outcomes

  • Dragana Radoičić1
  • Jelena Kljajević1
  • Ivan Nešić1
  • Matija Furtula1
  • Dalibor Dragišić2
  • Aleksandar Pavlović3
  • Milica Ivanović1
  • Slobodan Tomić1
  • Marko Kaitović1
  • Natalija Arnautović1
  • Armin Šljivo4
  • Aleksandar Milutinović5
5 affiliations
  1. 1Institute for Cardiovascular Disease “Dedinje”, 11000 Belgrade, Serbia
  2. 2Hospital Dragisa Misovic, 11040 Belgrade, Serbia
  3. 3Department for Cardiology, University Hospital Medical Center Bežanijska kosa, 11080 Belgrade, Serbia
  4. 4Department for Cardiovascular Surgery, Clinical Center of University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
  5. 5Department for Cardiovascular Surgery, University Children’s Hospital, “Tiršova”, 11000 Belgrade, Serbia
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Abstract

Introduction. This study aims to evaluate the outcomes of three distinct configurations of No-Touch (NT) grafts used in coronary artery bypass grafting, focusing on the safety and efficacy of these techniques. Methods. Nine cases were analysed and categorized into three groups: Coronaro-Coronary NT Left Internal Thoracic Artery (LITA) non-aortic composite grafts; NT-LITA ‘Y’ composite grafts, and a Posterior Descending-Obtuse Marginal-Aorta NT vein graft. Results. In Group 1, no traditional proximal anastomosis was performed. The NT vein graft was distally anastomosed to the obtuse marginal branch in an end-to-side manner, followed by side-to-side anastomosis to the Ramus Intermedius (RI) or Diagonal, and a final end-to-side connection to the Ramus Interventricularis Anterior (RIA). In Group 2, where NT-LITA ‘Y’ composite grafts were utilized, the first graft was placed end-to-side and the second side-to-side, addressing either two marginal branches or the OM and RI branches. Proximal anastomoses were occasionally performed to the LITA or aorta. In Group 3, a sequential anastomosis was conducted, with the NT vein graft connected from the right posterior descending artery in an end-to-side manner, followed by a side-to-side connection to the OM branch. Patients had patent No-Touch vein grafts on their follow-up MSCT, without any post-surgery complications, except 2 cases where one had occluded marginal branches, and one LITA-RIA anastomosis. Conclusions. Different No-Touch graft configurations demonstrate high patency rates and a favorable safety profile. Overall, graft patency was preserved in most patients during follow-up, although several anastomotic occlusions were observed. These findings suggest NT grafts are a viable alternative to traditional methods, warranting further research into long-term outcomes and surgical refinements.

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Cite

BibTeXRIS
BibTeX
@article{radoicic2026case,
  title = {{Case Series Analysis of No-Touch Graft Configurations in Coronary Artery Bypass Grafting: Comparative Outcomes}},
  author = {Dragana Radoičić and Jelena Kljajević and Ivan Nešić and Matija Furtula and Dalibor Dragišić and Aleksandar Pavlović and Milica Ivanović and Slobodan Tomić and Marko Kaitović and Natalija Arnautović and Armin Šljivo and Aleksandar Milutinović},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15208125},
  url = {https://www.mdpi.com/2077-0383/15/20/8125},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Case Series Analysis of No-Touch Graft Configurations in Coronary Artery Bypass Grafting: Comparative Outcomes
AU  - Dragana Radoičić
AU  - Jelena Kljajević
AU  - Ivan Nešić
AU  - Matija Furtula
AU  - Dalibor Dragišić
AU  - Aleksandar Pavlović
AU  - Milica Ivanović
AU  - Slobodan Tomić
AU  - Marko Kaitović
AU  - Natalija Arnautović
AU  - Armin Šljivo
AU  - Aleksandar Milutinović
PY  - 2026
DA  - 2026/10/01
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15208125
UR  - https://www.mdpi.com/2077-0383/15/20/8125
AB  - Introduction. This study aims to evaluate the outcomes of three distinct configurations of No-Touch (NT) grafts used in coronary artery bypass grafting, focusing on the safety and efficacy of these techniques. Methods. Nine cases were analysed and categorized into three groups: Coronaro-Coronary NT Left Internal Thoracic Artery (LITA) non-aortic composite grafts; NT-LITA ‘Y’ composite grafts, and a Posterior Descending-Obtuse Marginal-Aorta NT vein graft. Results. In Group 1, no traditional proximal anastomosis was performed. The NT vein graft was distally anastomosed to the obtuse marginal branch in an end-to-side manner, followed by side-to-side anastomosis to the Ramus Intermedius (RI) or Diagonal, and a final end-to-side connection to the Ramus Interventricularis Anterior (RIA). In Group 2, where NT-LITA ‘Y’ composite grafts were utilized, the first graft was placed end-to-side and the second side-to-side, addressing either two marginal branches or the OM and RI branches. Proximal anastomoses were occasionally performed to the LITA or aorta. In Group 3, a sequential anastomosis was conducted, with the NT vein graft connected from the right posterior descending artery in an end-to-side manner, followed by a side-to-side connection to the OM branch. Patients had patent No-Touch vein grafts on their follow-up MSCT, without any post-surgery complications, except 2 cases where one had occluded marginal branches, and one LITA-RIA anastomosis. Conclusions. Different No-Touch graft configurations demonstrate high patency rates and a favorable safety profile. Overall, graft patency was preserved in most patients during follow-up, although several anastomotic occlusions were observed. These findings suggest NT grafts are a viable alternative to traditional methods, warranting further research into long-term outcomes and surgical refinements.
SN  - 2077-0383
ER  -