Initial Experience with Endoscopic Saphenous Vein Harvesting for Coronary Artery Bypass Graft ing in Chinese Patients

2011 ◽  
Vol 14 (5) ◽  
pp. 291 ◽  
Author(s):  
Huishan Wang ◽  
Haibo Wu ◽  
Hui Jiang ◽  
Zengwei Wang ◽  
Evginij Potapov ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Chinese Patients ◽  
Invasive Technique ◽  
Initial Experience ◽  
Macroscopic Appearance ◽  
Vein Grafts ◽  
Vein Harvesting

<p><b>Objective:</b> We aimed to investigate the initial experience of endoscopic vein harvesting (EVH) for coronary artery bypass grafting (CABG) in Chinese patients.</p><p><b>Methods:</b> Forty patients scheduled for isolated CABG were prospectively randomized into an EVH group (n = 20) and an open vein harvesting (OVH) group (n = 20). Clinical data were collected, and all of the vein grafts were assessed by macroscopic appearance, histologic quality (endothelial integrity), and functional characteristics of endothelial nitric oxide synthase.</p><p><b>Results:</b> The 2 groups were similar with respect to hospital mortality (EVH group, 0; OVH group, 1; <i>P</i> = 1). There were no postoperative myocardial infarctions in either group and no deaths or reinterventions in either group during the follow-up period. Harvesting times in the 2 groups were similar (EVH, 12.15 � 2.32 min; OVH, 12.55 � 2.11 min; <i>P</i> = .571). Three patients in the EVH group were converted to a partly open or skin-bridge technique. Electrocautery at least 2 mm distal to the origin of the side branch was the safety margin.</p><p><b>Conclusions:</b> The use of EVH in Chinese patients was not related to adverse events and may be safely used for CABG procedures. Preoperative duplex mapping, systemic heparinization before harvesting, minimal surgical manipulation, and sectioning of side branches at least 2 mm distal to the origin may help improve the quality of vein grafts harvested with EVH and maximize the benefit of this less-invasive technique.</p>

scholarly journals Perioperative urinary thromboxane metabolites and outcome of coronary artery bypass grafting: a nested case-control study

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e021219
Author(s):  
Hanning Liu ◽  
Zhengxi Xu ◽  
Cheng Sun ◽  
Qianlong Chen ◽  
Ning Bao ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Case Control Study ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Case Control ◽  
Chinese Patients ◽  
Cabg Surgery ◽  
Nested Case Control ◽  
Control Study

ObjectiveAs a marker of in vivo thromboxane generation, high-level urinary thromboxane metabolites (TXA-M) increase the occurrence of cardiovascular events in high-risk patients. To investigate whether perioperative urinary TXA-M level is associated with major adverse cardiac and cerebrovascular events (MACCE) after coronary artery bypass graft (CABG) surgery, we designed a nested case-control study.DesignObservational, nested case-control study.SettingSingle-centre outcomes research in Fuwai Hospital, Beijing, China.ParticipantsOne thousand six hundred and seventy Chinese patients undergoing CABG surgery from September 2011 to October 2013.MethodsWe obtained urinary samples from 1670 Chinese patients undergoing CABG 1 hour before surgery (pre-CABG), and 6 hours (post-CABG 6 hours) and 24 hours after surgery (post-CABG 24 hours). Patients were followed up for 1 year, and we observed 56 patients had MACCE. For each patient with MACCE, we matched three control subjects. Perioperative urinary TXA-M of the three time spots was detected in these 224 patients.ResultsPost-CABG 24 hours TXA-M is significantly higher than that of patients without MACCE (11 101vs8849 pg/mg creatine, P=0.007). In addition, patients in the intermediate tertile and upper tertile of post-CABG 24 hours urinary TXA-M have a 2.2 times higher (HR 2.22, 95% CI 1.04 to 4.71, P=0.038) and a 2.8 times higher (HR 2.81, 95% CI 1.35 to 5.85, P=0.006) risk of 1 year MACCE than those in the lower tertile, respectively.ConclusionsIn conclusion, post-CABG 24 hours urinary TXA-M elevation is associated with an increase of 1 year adverse events after CABG, indicating that the induction of cyclo-oxygenase-2 by surgery-related inflammatory stimuli or platelet turnover may be responsible for the high levels of post-CABG urinary TXA-M.Trial registration numberNCT01573143.

Coronary artery bypass graft angiography

2020 ◽  
pp. 165-181
Author(s):  
Andrew Mitchell ◽  
Giovanni Luigi De Maria ◽  
Adrian Banning
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Arterial Grafts ◽  
Clinical Images ◽  
Vein Grafts ◽  
Total Arterial Revascularization

Most patients undergoing coronary artery bypass grafting, or CABG, in the past decade will have had a combination of arterial grafts and saphenous vein grafts (or received total arterial revascularization), as conduit patency for mammary arterial grafts has been shown to be significantly higher than that of vein grafts. This chapter covers one of the most common operations performed on patients with three-vessel coronary disease. It describes the role of pre-angiography, choosing an appropriate catheter, and the location of various grafts. It is fully illustrated with clinical images throughout, annotated to aid understanding.

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