title: A randomized comparison of the Saphenous Vein Versus Right Internal Thoracic Artery as a Y-Composite Graft (SAVE RITA) trial: early results.
abstract: OBJECTIVE
  The Saphenous Vein Versus Right Internal Thoracic Artery as a Y-Composite Graft trial was designed to evaluate the saphenous vein compared with the right internal thoracic artery as a Y-composite graft anastomosed to the side of the left internal thoracic artery. In this early analysis, we compared early angiographic patency rates and clinical outcomes.
  
  
  METHODS
  From September 2008 to October 2011, 224 patients with multivessel coronary artery disease were randomized prospectively to undergo off-pump revascularization using the saphenous vein group (n = 112) or the right internal thoracic artery group (n = 112) as Y-composite grafts. Early postoperative (1.4 ± 1.1 days) angiographic patency and clinical outcomes were compared.
  
  
  RESULTS
  There was 1 operative death in the right internal thoracic artery group. No statistically significant differences in postoperative morbidities, including atrial fibrillation and acute renal failure, were observed between the groups. The number of distal anastomoses using the side-arm Y-composite graft (saphenous vein vs right internal thoracic artery) were 2.3 ± 0.8 and 1.9 ± 0.7 in the saphenous vein and right internal thoracic artery groups, respectively (P < .001). A third conduit was used in 44 patients (saphenous vein group vs right internal thoracic artery group, 4/109 vs 40/110; P < .001) to extend the side-arm Y-composite graft for complete revascularization. Early angiography demonstrated an overall patency rate of 99.4% (771 of 776 distal anastomoses). Patency rates of the side-arm Y-composite graft (saphenous vein vs right internal thoracic artery) were 98.8% (245 of 248) and 99.5% (207 of 208) in the saphenous vein and right internal thoracic artery groups, respectively (P = .629).
  
  
  CONCLUSIONS
  A third conduit was needed to extend the right internal thoracic artery composite graft and reach the target vessels in 36.4% (40/110) of the patients. The saphenous vein composite graft was comparable with the right internal thoracic artery composite graft in terms of early angiographic patency and clinical outcomes.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Ho Young
authors.initials: HY
authors.lastname: Hwang
authors.forename: Jun Sung
authors.initials: JS
authors.lastname: Kim
authors.forename: Se Jin
authors.initials: SJ
authors.lastname: Oh
authors.forename: Ki-Bong
authors.initials: KB
authors.lastname: Kim
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D017052:Hospital Mortality; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D056910:Republic of Korea; D018570:Risk Assessment; D012307:Risk Factors; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency