An interventional study of Y-composite grafting and Aortocoronary grafting in Coronary Artery Disease, sponsored by Ho Young Hwang. Recruiting at 1 site in South Korea. Open to participants aged 19 Years and older. Per ClinicalTrials.gov, last updated 2026-09-17.
Sponsored by Ho Young Hwang · Not applicable, Interventional, and Treatment
Left internal thoracic artery (LITA) has been acknowledged as the first graft of choice for coronary artery bypass grafting (CABG). However, it is still not conclusive which one is the best second graft of choice among right internal thoracic artery, radial artery, right gastroepiploic artery, saphenous vein, and etc., as well as its configuration for CABG.
In our institution, saphenous vein has been primarily used for the second graft and we have harvested it with 'No touch technique'. We have been demonstrated the excellent long-term patency of this 'No touch saphenous vein' in many studies. However, it is still unknown which configuration is the better strategy for the saphenous vein as a Y-composite graft based on the left internal thoracic artery versus an aortocoronary conduit. Thus, we aimed to evaluate morphologic change of saphenous vein graft by 1-year intravascular ultrasound (IVUS) study and angiographic patency results between Y-composite graft and aortocoronary conduit.
The enrolled patient underwent routine sternotomy, and left internal thoracic artery (LITA) and saphenous vein (SV) are harvested. After harvest, the patient is randomized to Y-composite group or aortocoronary group.
For Y-composite group, SV is anastomosed to LITA as Y-composite fashion. Then, LITA is anastomosed to left anterior descending artery. SV is anastomosed to the rest of the target vessels with sequential anastomosis technique (e.g. diagonal branch, obtuse marginal branch, posterolateral branch and posterior descending artery).
For aortocoronary group, LITA is anastomosed to left anterior descending artery. Then, SV is anastomosed to ascending aorta using proximal anastomosis assist device without clamping the aorta. SV is anastomosed to the rest of the target vessels with sequential anastomosis technique (e.g. diagonal branch, obtuse marginal branch, posterolateral branch and posteriori descending artery).
At 1-year follow-up, coronary angiography is performed to evaluate the patency of the saphenous vein graft. Clinical outcomes are also evaluated.
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The saphenous vein is anastomosed to the middle portion of the left internal thoracic artery as Y-composite fashion. Then, left anterior descending artery, if targeted, is bypassed with left internal thoracic artery. Other native coronary arterial targets are bypassed with saphenous vein graft.
Procedure: Y-composite grafting
The saphenous vein is anastomosed to the ascending aorta as aortocoronary fashion. Then, left anterior descending artery, if targeted, is bypassed with left internal thoracic artery. Other native coronary arterial targets are bypassed with saphenous vein graft.
Procedure: Aortocoronary grafting
Saphenous vein is used as a Y-composite graft during coronary artery bypass grafting
Saphenous vein is used as an aortocoronary graft during coronary artery bypass grafting
Graft patency
Graft patency measured by coronary angiography
Time frame: at postoperative 1 year
All-cause mortality
all deaths from any cause
Time frame: at postoperative 1 year
Cardiac death
Any death related to cardiac events, including sudden death during follow-up
Time frame: at postoperative 1 year
Target vessel revascularization
Intervention performed for the previously bypassed target vessel during follow-up
Time frame: at postoperative 1 year
Reintervention
Any coronary intervention performed during follow-up due to the coronary artery disease
Time frame: at postoperative 1 year
Major Adverse Cardiac Events (MACEs)
acute myocardial infarction, coronary reintervention, and cardiac death including sudden death during follow-up
Time frame: at postoperative 1 year
Plan to share: No — Individual participant data will not be shared because it is not allowed by our Institutional Review Board.
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Ho Young Hwang