scholarly journals Predictive value of great saphenous vein mapping prior to endoscopic harvesting in coronary artery bypass surgery

2020 ◽  
Vol 31 (1) ◽  
pp. 16-19
Author(s):  
Ferdi Akca ◽  
Ka Yan Lam ◽  
Niels Verberkmoes ◽  
Ignace de Lathauwer ◽  
Mohamed Soliman-Hamad ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Predictive Value ◽  
Great Saphenous Vein ◽  
Artery Bypass ◽  
Endoscopic Vein Harvesting ◽  
Preoperative Mapping ◽  
Coronary Bypass Grafts ◽  
Vein Harvesting

Abstract OBJECTIVES The use of endoscopic vein harvesting in patients undergoing coronary artery bypass grafting is increasing, often using bedside mapping. However, data on the predictive value of great saphenous vein (GSV) mapping are scarce. This study assessed whether preoperative mapping could predict final conduit diameter. METHODS A prospective registry was created that included 251 patients. Saphenous vein mapping was performed prior to endoscopic vein harvesting at 3 predetermined sites. After harvesting and preparing the GSV, the outer diameters were measured. Appropriate graft size was defined as an outer diameter between 3 and 6 mm. RESULTS A total of 753 GSV segments were analysed. The average mapping diameter was 3.2 ± 0.7 mm. The harvested GSV had a mean diameter of 4.7 ± 0.8 mm. Mapping diameters were significantly positively correlated with actual GSV diameters (correlation coefficient, 0.47; P < 0.001). If the preoperative mapping diameters were between 1.5 and 5 mm, 96.6% of the GSVs had suitable dimensions after endoscopic vein harvesting. CONCLUSIONS Preoperative bedside mapping moderately predicts final GSV size after endoscopic harvesting but could not detect unsuitable vein segments. However, the majority of endoscopically harvested GSVs had diameters suitable to be used as coronary bypass grafts.

scholarly journals A Prospective Audit of Endoscopic Vein Harvesting for Coronary Artery Bypass Surgery

2009 ◽  
Vol 91 (5) ◽  
pp. 426-429 ◽  
Author(s):  
Zakariya Waqar-Uddin ◽  
Manoj Purohit ◽  
Nadene Blakeman ◽  
Joseph Zacharias
Keyword(s):  
Patient Satisfaction ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Coronary Artery Bypass Surgery ◽  
Artery Bypass ◽  
Prospective Audit ◽  
Endoscopic Vein Harvesting ◽  
Long Saphenous Vein ◽  
Vein Harvesting

INTRODUCTION The objectives of this study were to: (i) assess the feasibility of minimally invasive endoscopic harvesting of the long saphenous vein or radial artery for use as conduit during coronary artery bypass surgery in the NHS setting; and (ii) investigate the results of endoscopic vein harvesting with regards to postoperative complications, ability to mobilise, and patient satisfaction. PATIENTS AND METHODS In this prospective audit, 25 consecutive patients, aged 52–90 years, undergoing either coronary artery bypass grafting alone or together with valve surgery or atrial fibrillation ablation were studied. All data were entered in purpose-designed proforma. Pre-operative risk factors including increasing age, diabetes, peripheral vascular disease, obesity, renal impairment, tobacco consumption and steroid use were documented. Time taken for harvest and conversion to traditional open vein harvest, quality of harvested vein in terms of number of repairs and vein damage were recorded. Postoperatively, we recorded harvest site wound complications, number of days to mobilise and total hospital stay. Pain score and patient satisfaction were also assessed. RESULTS There was one death due to myocardial infarction; another patient had postoperative cerebrovascular accident. A total of 43 lengths of grafts were harvested, 41 were long saphenous vein and two radial artery. Vein harvest time reduced significantly from a maximum of 94 min to 34 min for two lengths of long saphenous vein. Three patients required conversion from endoscopic vein harvesting to open vein harvest. The only postoperative complication directly related to endoscopic harvesting was bruising along the tunnel created by the passage of the instruments. None of the patients had any wound complication; none required antibiotics or wound debridement. Mean time to mobilise was 3.4 days. All patients who underwent successful endoscopic vein harvesting expressed satisfaction with regards to postoperative pain and cosmetic result. CONCLUSIONS Competence and ability to harvest conduit in an acceptable time frame are obtainable after a relatively low number of cases. The procedure is associated with a low number of postoperative complications and very high patient satisfaction.

scholarly journals Endoscopic vein harvesting in coronary artery bypass surgery

2014 ◽  
Vol 95 (3) ◽  
pp. 455-459
Author(s):  
A G Varlamov ◽  
A R Sadykov ◽  
R K Dzhordzhikiya
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Wound Complications ◽  
Pain Patient ◽  
Endoscopic Vein Harvesting ◽  
Vein Harvesting

The greater saphenous vein is the most available and frequently used conduit for coronary artery bypass grafting. Conventional (open) vein harvesting procedure requires the longitudinal skin and subcutaneous fat incision along the full conduit length. Endoscopic vein harvesting has been developed in the middle-1990s as less invasive alternative for open vein harvesting. Using this novel technique allows to harvest the whole greater saphenous vein through 3 cm long skin incision. The article reviews the history, the role and current status of endoscopic vein harvesting in coronary artery bypass surgery. Literature data of the impact of that minimally invasive approach on infective and non-infective leg wound complications, as well as postoperative pain, patient satisfaction and live quality are presented. The cost-effectiveness data of the method, resulting in reduction of treatment costs of leg wound complications both at the hospital and after patient’s discharge are mentioned. The influence of endoscopic vein harvesting on morphologic and functional conduit quality is discussed. Special attention is devoted to mid- and long-term outcomes after coronary artery bypass surgery with endoscopic vein harvesting. The majority of research including angiographic control gives evidence of comparable parameters of bypass patency after the conventional vein harvesting and endoscopic vein harvesting procedures. Recent multicenter trials showed no statistically significant differences between the conventional vein harvesting and endoscopic vein harvesting procedures in such indirect graft patency indicators as mortality, myocardial infarction rate, need for repeated revascularization and recurrence of angina pectoris. Recent findings advocate safety and clinical effectiveness of endoscopic vein harvesting.

scholarly journals EEffect of Great Saphenous Vein Harvesting in Lower Limb Following Coronary Artery Bypass Grafting in Diabetic Patients

KYAMC Journal ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 59-61
Author(s):  
Mahbub Ahsan ◽  
Md Abul Kashem ◽  
Md Golam Kibria
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Lower Limb ◽  
Great Saphenous Vein ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Myocardial Revascularization ◽  
Diabetic Patients ◽  
Vein Harvesting

Background: Coronary artery bypass graft Surgery is an established method of myocardial revascularization. Great saphenous vein is the conduit of choice for all cardiac surgeons. Objective: To compare the effect of great saphenous vein harvesting on lower limb such as swelling, pain, discharge with diabetic and non diabetic CABG patients in whom great saphenous vein was used as a conduit. Materials and Methods: It was a cross sectional study on 60 patients who underwent CABG during July 2003 to June 2005 in department of cardiovascular surgery, National Institute of Cardiovascular Diseases (NICVD). Results: The age in group A (Diabetic) ranged from 40-72 years in group B (Non Diabetic) the age range was 40-65 years. Myocardial infarction and Congestive cardiac failure were the predominant risk factors in both age groups. There was no motor or sensory disturbances post operatively. Some patients developed swelling, tenderness, paresthesia in both group but it was not statistically significant. Conclusion: Morbidity occurs in both diabetic and non diabetic patients with certain complications like numbness, paresthesia, swelling etc. at the harvesting site. KYAMC Journal Vol. 11, No.-2, July 2020, Page 59-61

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