scholarly journals Remote patency of aortocoronary bypass grafts after endoscopic and conventional great saphenous vein harvesting

2016 ◽  
Vol 97 (4) ◽  
pp. 486-492
Author(s):  
A G Varlamov ◽  
R K Dzhordzhikiya ◽  
A R Sadykov
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Aortocoronary Bypass ◽  
Bypass Grafts ◽  
Cardiac Events ◽  
Endoscopic Vein Harvesting ◽  
Group Frequency ◽  
Vein Harvesting

Aim. To compare patency of aortocoronary bypass grafts in remote period after endoscopic and conventional (open) great saphenous vein harvesting. To analyze the patency of aortocoronary bypass grafts after endoscopic vein harvesting from calf and thigh.Methods. The study involved 170 patients who underwent elective isolated coronary artery bypass grafting. Treatment results were evaluated in two prospectively formed groups: endoscopic (85 patients) and open (85 people) vein harvesting. Endoscopic vein harvesting was performed both from the calf and from the thigh through popliteal access using endoscopic system Vasoview 6.0. Patency of autovenous aortocoronary grafts was studied in 2.6±1.17 years after surgery using 64-slice contrast-enhanced MDCT or traditional angiography. Angiographic follow-up covered 76 patients with endoscopic vein harvesting and 79 patients with open vein harvesting.Results. The studied groups did not differ in the frequency of detection of occluded, stenotic and fully patent autovenous aortocoronary bypass grafts (p=0.841). In endoscopic vein harvesting group frequency of autovenous aortocoronary bypass grafts occlusion was 25.7%, in the group of open vein harvesting - 25.1% (p=0.984). There was no difference in the patency of internal thoracic artery grafts to the left anterior descending artery (p=0.227), and freedom from adverse cardiac events (p=0.342). Occlusion of autovenous grafts after endoscopic harvesting from the calf developed less frequently than after endoscopic harvesting from the thigh (15.1 vs. 34.6%; p=0.013). Grafts after endoscopic harvesting in the knee region occluded most often (41.9%). Patency of aortocoronary bypass grafts after open vein harvesting was not dependent on the area of the vein harvesting (p=0.900).Conclusion. Endoscopic vein harvesting does not compromise the patency of aortocoronary bypass graft and does not increase the risk of its occlusion; endoscopic harvesting of the veins from the calf improves indicators of aortocoronary grafts patency and reduces the risk of graft failure (odds ratio 0.3; 95% confidence interval 0.14-0.8; p = 0.013).

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 Leg Wound Complications: A Comparison Between Endoscopic and Open Saphenous Vein Harvesting Techniques

2021 ◽  
Vol 24 (4) ◽  
pp. E604-E610
Author(s):  
Yasser Mubarak ◽  
Ahmed Abdeljawad
Keyword(s):  
Saphenous Vein ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Group Versus ◽  
Early Mobilization ◽  
Wound Complications ◽  
Endoscopic Vein Harvesting ◽  
Harvesting Technique ◽  
Vein Harvesting

Background: The most common conduit for coronary artery bypass graft (CABG) surgery is saphenous vein graft (SVG). There are two techniques for SVG harvesting: open and endoscopic. Our aim is to evaluate clinical results of endoscopic versus open SVG harvesting. Nowadays, endoscopic vein harvesting (EVH) has become prevalent because of reduced complications with more patient satisfaction. Objective: We designed and performed a prospective randomized cohort study of patients undergoing CABG to compare the results of open versus endoscopic harvesting technique. Methods: Patients who underwent elective CABG at our hospitals were divided into two groups, during the period of January 2019 to March 2021. The EVH group (50 patients) underwent endoscopic technique compared with the open vein harvesting (OVH) group (50 patients) that was underwent open surgical incision for great saphenous vein (GSV) harvesting. The two groups demographically were similar and received identical management. Leg wound was evaluated at discharge, two weeks, and four weeks for evidence of any complications. Early outcomes were recorded, including infection, gaped wound and surgical re-suture, degree of pain, level of cosmetic satisfaction, and early mobilization. Results: In the EVH group, harvesting time increased, and incision closure time decreased in comparison with OVH. The hospital stay was 5.5 ± 2.4 days in the EVH group versus 9.5 ± 2.7 days in the OVH group. Leg wound complications were significantly reduced in the EVH group in comparison with the OVH group. Conclusions: Endoscopic vein harvesting technique reduced leg wound complications. Conveniently, patients also were cosmetically satisfied.

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

Abstract P158: Long-Term Outcomes of Endoscopic Vein Harvesting After Coronary Artery Bypass Grafting

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Lawrence Dacey ◽  
John Braxton ◽  
Robert Kramer ◽  
Joseph Schmoker ◽  
David Charlesworth ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Saphenous Vein ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Endoscopic Vein Harvesting ◽  
Repeat Revascularization ◽  
Risk Of Mortality ◽  
Vein Harvesting

Introduction: Endoscopic saphenous vein harvesting has developed into a standard of care at many cardiothoracic surgical centers. The association between this technique and long-term morbidity and mortality has recently been called into question. We describe the association between use of open versus endoscopic vein harvesting and the risk of mortality and repeat revascularization within northern New England during a time period (2001-2004) in which both techniques were being performed. Methods: Prospective cohort study. From 2001-2004, 52.5% (4,485 of 8,542) of patients undergoing isolated coronary artery bypass grafting surgery had their saphenous vein harvested endoscopically. Surgical discretion dictated the vein harvest approach. Results: Use of endoscopic vein harvesting increased from 34% (781 of 2,291) in 2001 to 75% (1,341 of 1,792) in 2004. Patients undergoing endoscopic vein harvesting had greater disease burden. Endoscopic vein harvesting was associated with a significant reduction in long-term mortality [adjHR: 0.79, (CI 95% 0.68, 0.91)] and risk of repeat revascularization or mortality [adjHR: 0.87, (CI 95% 0.78, 0.98), Figure]. Endoscopic vein harvesting was associated with a non-significant increased risk of repeat revascularization [adjHR: 1.08, (CI 95% 0.89, 1.31)]. Similar results were obtained in a propensity-matched analysis. Conclusion: The use of endoscopic vein harvesting was associated with a reduced risk of mortality as well as a composite endpoint of mortality or repeat revascularization four years after the index admission. This practice insignificantly increased the risk of repeat revascularization.

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.

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