scholarly journals Effect of Endoscopic Versus Open Saphenous Vein Harvesting Technique on Leg Wound Complications

2020 ◽  
Author(s):  
Yasser Mubarak
Keyword(s):  
Saphenous Vein ◽  
Artery Bypass ◽  
Wound Complications ◽  
Endoscopic Vein Harvesting ◽  
Patient’S Satisfaction ◽  
Harvesting Technique ◽  
Incision Location ◽  
Open Versus ◽  
A Prospective Study ◽  
Vein Harvesting

Background: EVH has become prevalent in recent years due to its reduced morbidity and increased patient satisfaction. We designed and carried out a prospective study of patients undergoing CABG to compare outcomes of open versus endoscopic harvesting technique for great saphenous vein. Two groups of patients who underwent elective Coronary artery bypass grafting at our hospitals between January 2018 and October 2020 were included. Endoscopic vein harvesting group (50 patients) was performed endoscopic technique compared with Open Vein Harvesting group (50 patients) was performed open surgical incision for harvesting. Both groups were demographically similar and received identical management. Leg wound was evaluated at discharge, 2 weeks, and 4 weeks for evidence of complications. Early outcomes were compared included, infection, gaped wound and re-suture, pain, satisfied cosmetically and mobilization. Results: Endoscopic vein harvesting group had increased harvest time and decreased incision closure time when compared with Open Vein Harvesting. The average hospitalization time was 6.5 ± 2.2 days for Endoscopic vein harvesting group and 9.2 ± 2.9 days for Open Vein Harvesting group. In Endoscopic vein harvesting group, no significant hematomas were observed. In Open Vein Harvesting group, hematomas were detected in 2 patients and were surgically evacuated. In Endoscopic vein harvesting group, edema occurred less frequently. Infection of the incision location did not occur in Endoscopic vein harvesting group. Leg wound complications were significantly reduced in Endoscopic vein harvesting group in comparison with Open Vein Harvesting group. Conclusions: Endoscopic vein harvesting decreases leg wound complications and increases patient’s satisfaction cosmetically.

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.

A Novel Technique of Endoscopic Vein Harvesting With Preserved Perivascular Tissue

2020 ◽  
Vol 15 (5) ◽  
pp. 475-477
Author(s):  
Kunihiko Yoshino ◽  
Kohei Abe ◽  
Koyu Suzuki ◽  
Rihito Tamaki ◽  
Atusyuki Mituishi ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Histopathological Examination ◽  
Wound Complications ◽  
Connective Tissues ◽  
Endoscopic Vein Harvesting ◽  
Harvesting Technique ◽  
A New Technique ◽  
Vein Harvesting ◽  
The Ideal

The no-touch saphenous vein harvesting technique is considered to be the ideal procedure to achieve the best quality of vein, whereas the endoscopic vein harvesting (EVH) technique is considered to be ideal for decreasing wound complications. We developed a new technique of EVH with perivascular tissue preservation. This procedure was performed by dissecting the immediate anterior and posterior perivascular connective tissues of the saphenous vein followed by cutting approximately 1 cm laterally from the saphenous vein with the use of a harvester (MAQUET Getinge Group, Getinge AB, Göteborg, Sweden). Histopathological examination revealed preserved perivascular tissue and intimal folding.

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.

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.

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 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).

No-Touch Sequential Saphenous Venous Harvesting Technique in Off-Pump Bypass Surgery: A Retrospective Study

2021 ◽  
Author(s):  
Xuejian Hou ◽  
Kui Zhang ◽  
Taoshuai Liu ◽  
Yang Li ◽  
Yang Zhao ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Conventional Technique ◽  
Wound Complications ◽  
Off Pump ◽  
Vein Grafts ◽  
Harvesting Technique ◽  
Significant Difference ◽  
Pump Cabg

Abstract Background In the mid-1990s, the Swedish expert team proposed saphenous vein graft (SVG) harvesting with pedicle tissue. The short-term and long-term patency rates of the great saphenous vein obtained by the no-touch technique (NT) were higher than those obtained by the conventional technique (CON). In the past, NT technology was mainly used in on-pump coronary artery bypass grafting (CABG), and vein grafts were mostly single vein grafts. In this study, we retrospectively analysed the safety and effectiveness of sequential vein grafts using NT technology in off-pump CABG. Methods From 2017 to 2019, a total of 505 patients were included in the study. There were 150 patients in the NT group and 355 patients in the CON group. After applying propensity score matching (1:1 matching), 148 patients were included in each group. Baseline data, graft patency, postoperative complications, leg wound complications and 1-year major adverse cardiac and cerebrovascular events (MACCEs) were compared between the two groups. Results There was no significant difference in the patency rate of sequential venous grafts between the two groups one year after the operation either before (NT: 7.1% (10/141) vs CON: 11.5% (38/331), p = 0.149) or after matching (NT: 7.1% (10/140) vs CON: 7.3% (9/124), p = 0.971). There was no significant difference in the composite clinical endpoint between the two groups either before (NT: 3 (2.3%) vs CON: 9 (2.8%), p = 1.000) or after matching (NT: 3 (2.3%) vs CON: 3 (2.5%), p = 1.000). There were differences in leg wound complications between the two groups both before (NT: 9 (6.9%) vs CON: 6 (1.9%), p = 0.007) and after matching (NT: 9 (6.9%) vs CON: 2 (1.7%), p = 0.043). Conclusions The application of the NT technique in off-pump CABG with sequential vein grafts is safe and effective. Leg wound complications are more common with the NT technique than with the conventional technique.

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