Application of endoscopic saphenous vein harvesting in coronary artery bypass grafting
0
Citation
0
Reference
20
Related Paper
Abstract:
Objective To summarize the early clinical results of application of endoscopic saphenous vein harvesting(EVH)in coronary artery bypass grafting.Methods From January 2010 to December 2010,84 consecutive patients underwent coronary artery bypass grafting(CABG),EVH in 36 cases and the multiple interrupted incisions in 48 cases.Results There was no significantly different saphenous vein in the length between the two groups(P 0.05).But,EVH group had longer harvesting time,shorter incisions length and less suture time than the other group(all P 0.05).Within 1 month after surgery,EVH group presented significantly lower wound-related complication rate than the multiple interrupted incisions group 13.9%(5/36) vs.37.5%(18/48)(P 0.05).Conclusion EVH is a safe and recommended alternative technique for harvesting saphenous vein in coronary artery bypass grafting.Keywords:
Great saphenous vein
Derivation
Cite
OBJECTIVE: Saphenous vein harvesting can be associated with wound complications, incision pain, infection, and poor cosmetic outcome. The objective of our study is to determine the difference in wound complication and infection rates between two saphenous vein harvesting techniques, long incision versus multiple short interrupted incisions (tunneling) for coronary artery bypass grafting at the King Abdullah University Hospital - Jordan. METHODS: Retrospectively we analyzed data from 1,050 consecutive elective coronary artery bypass procedures performed from May 5, 2003, to December 31, 2007, in our institution. Saphenectomy using traditional Long incision vein harvesting (Group 1) performed in six hundred and fifty patients (n=650), while saphenectomy using multiple incisions with small skin bridges - tunneling (Group 2) performed in four hundred patients (n=400). Saphenectomy performed by the cardiac surgery assistant or main cardiac surgeon. Inflammation, dehiscence, cellulites, lymphangitis, drainage, necrosis, or abscess necessitating dressing, antibiotics or debridement before complete healing without eschar were defined as wound complications. There was no statistical difference in preoperative risk factors in both groups. Test results were considered significant when P<0.05. RESULTS: Leg wound complications observed more in traditional long incision vein harvesting technique (P=0.0005). Female gender, obesity, diabetes are associated with an increased incidence of wound problems (P<0.05). CONCLUSIONS: Saphenous vein harvest using saphenous vein tunneling was associated with fewer wound complications than the traditional longitudinal method.
Groin
Wound dehiscence
Cite
Citations (12)
Objective To observe the effects of endoscopic saphenous vein harvesting technique on the prevalence of leg-wound complications after coronary artery bypass grafting,and assess the feasibility of this technique and the potential trauma of the conduits.Methods Between January 2007 and February 2008,118 patients underwent primary coronary artery bypass grafting,and 40 patients' saphenous vein taken using endoscopic harvest system(EVH),and the others by open vein harvesting(OVH),based on patient's willingness.The operation risk factors were compared between the two groups,and the proximal vein segment that underwent endoscopic harvesting was examined with electron-microscope.Results There was no significant difference in risk factors of incision complications between the two groups,but the incidence of various incision complications was significantly lower in the EVH group(12.5%)than in the OVH group(39.7%)(P0.01).The time of harvesting was similar between the two groups.The length of conduits was(30.3±7.45)cm and(37.7±8.01)cm with significant difference between the two groups(P0.05).Actually,there was increase in the use of sequential grafting technique in the EVH group for revascularization.Histological studies suggested that there were no extra vein trauma associated with EVH.At the same time,we have accumulated rich experience and skills in this procedure,and realized anatomical features of vein grafts.However,because of limited experience,the patency rate of conduits and the incidence rate of myocardial infarction in the perioperative or postoperative period were not compared between the two groups,more precise observations might be required.Conclusion The decrease in incision complications of EVH was unquestionably superior to those of OVH,especially for those patients having risk factors of incision complications.With increasing experience,the EVH technique might replace conventional saphenous vein harvesting methods and become the standard option.
Great saphenous vein
Cite
Citations (0)
Objective To observe the influence of endoscopic harvesting technique on the prevalence of leg-wound complications after coronary artery bypass grafting, and to assess histologically the potential trauma to the vein. Methods From August,2003 to August, 2005, 256 patients undergoing CABG had saphenous vein harvested by endoscopic harvesting system. About 4 mm proximal and distal vein end segment of 10 patient undergoing endosocopic and conventional harvesting respectively were examined with light and electro-microscope. Results The mean number of vein grafts of ESVH was 2.2 and the mean endoscopic harvest time was (45±20) minutes. There was no complication (incision infection, edema of lower extremity, lymphangitis and fat necrosis) occurred. Stay in bed time was 2～3 days. There was no difference in result of light and electro-microscopy. Conclusion Endoscopic vein harvesting in coronary artery bypass grafting can decreases the prevalence of postoperative leg-wound infections, postoperative pain, lying time and hospital stay, and increase the postoperative mobility ability, especially in patient with obesity and diabetes mellitus. Furthermore, the endoscopic harvesting technique may do no additional trauma to the saphenous vein.
Great saphenous vein
Cite
Citations (1)
Endoscopic saphenous vein harvest( EVH) for coronary artery bypass grafting( CABG) has been proved to be effective in reduced wound complications without compromising graft patency and mortality. Although EVH was usually performed from femoral site, we performed endoscopic long saphenous vein harvest( ELSH) from femoral to below the knee through a single small incision. There were few reports in EVH from below the knee and ELSH.Between September 2012 and June 2014, 13 patients who underwent ELSH in CABG. We assessed the initial evaluation in ELSH using the VirtuoSaph system. ELSH was performed by our unified procedure protocol to harvest good saphenous vein graft.The success rate of ELSH was 100% (13/13). The harvest time was 83.6±15.2 min, graft length was 52.1±5.6 cm, and number of side branches requiring repair was 2.6±1.6. Beating CABG was performed in all patients. The number of distal anastomoses was 3.8±0.8. Sequential bypass was 12 in total 23 saphenous vein grafts. The early patency was 95% (18/19 grafts) as evaluated by postoperative angiography or coronary enhanced computed tomography. All patients except 1( hospital death)were discharged without major or wound complications.The acceptable results and outcomes were demonstrated by our ELSH procedure protocol. ELSH is considered to be a feasible procedure to harvest enough graft length for 2 CABG and keep the other side of saphenous vein graft intact.
Great saphenous vein
Cite
Citations (0)
Objective: To observe the clinical effects of endoscopic great saphenous vein harvesting in coronary artery bypass grafting. Methods: Endoscopic great saphenous vein harvesting was perfermed in 26 patients undergoing coronary artery bypass grafting (CABG). We observed the operation and the incidence of postoperative leg-wound. Results: The mean endoscopic harvest time was (35.6±11.8) minutes. No complications (incision infection, edema of lower extremity, lymphangitis and fat necrosis) occurred. Stay in bed time was 2 days, stay in hospital time was 6 days. Conclusion: Use of endoscopic vein harvesting in coronary artery bypass grafting decreases the incidence of postoperative leg-wound infections, postoperative pain and length of hospital stay.
Great saphenous vein
Cite
Citations (0)
Retractor
Great saphenous vein
Claudication
Cite
Citations (40)
Cite
Citations (0)
Objective To compare the clinical effects of endoscopic saphenous vein harvesting and traditional surgical management in coronary artery bypass grafting(CABG).Methods Between march 2007 to June 2008,215 patients underwent CABG.Among them,87 patients underwent endoscopic saphenous vein harvesting.At the same time,128 cases were managed by traditional ways.Results The cases were foUowed up for 1-17 months.Endoscopic great saphenous vein harvesting was superior to traditional management in the healing of wound infection,relief of pain,improvement of edema and skin feeling(P＜0.05).Conclusion Endoscope saphenous vein harvesting is an efficient technique for CABG which is characterized by less trauma and fewer wound complications,and will not influcence the function of vein as well.On the other hand,the satisfaction is improved.
Key words:
Coronary artery bypass grafting; Endoscopy; Saphenous vein
Great saphenous vein
Cite
Citations (0)
Great saphenous vein
Concomitant
Cite
Citations (12)
【Objective】 To evaluate the outcome of minimally invasive endoscopic saphenous vein harvesting(MIEVH) in coronary artery bypass grafts(CABG) myocardial revascularization and introduce experience in its performance.【Methods】 In 142 CABG cases,traditional open vein harvesting was performed in 79 cases and MIEVH in 63 cases.【Results】 MIEVH may decrease wound complications and obtain mini-incision.Infection of incision,pain and edema of lower extremity in MIEVH were significantly less than in traditional open vein harvesting(P 0.05).Follow-up lasted for 4~13(mean 8.6) months,good postoperative results for CABG can be achieved.【Conlusions】 MIEVH is a safe and efficient technique for CABG.It was associated with fewer wound complications.
Myocardial Revascularization
Great saphenous vein
Cite
Citations (0)