Article thumbnail

Endoscopic Vein Harvesting for Coronary Bypass Grafting: A Blessing or a Trojan Horse?

By Ryan Accord and Jos Maessen

Abstract

Conventional open harvest of the great saphenous vein (GSV) during CABG results in approximately 7% donor-site complications. Using endoscopic vein harvesting (EVH) the full GSV length can be harvested through a 3 cm incision. This nonsystematic review discusses several key issues concerning EVH, based on an extensive Pubmed search. Found studies show that EVH results in reduced number of wound complications, less postoperative pain, earlier postoperative mobilisation, reduced length of hospital stay, and is more cost-effective. Initial studies did not find significant differences in graft histology, patency, or clinical outcome. However, in 2009 convincing evidence of inferior histological graft properties became available. Furthermore, an observational study showed that EVH resulted in significantly more graft stenosis, was associated with higher mortality, more myocard infarction, and more reinterventions. Most recent publications could not confirm these findings, however larger randomised controlled trials focusing on graft quality are being awaited

Topics: Review Article
Publisher: SAGE-Hindawi Access to Research
OAI identifier: oai:pubmedcentral.nih.gov:3088095
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles

Citations

  1. (2001). A comparative study of endothelial cell injuryduringopenandendoscopicsaphenectomy:anelectron microscopic evaluation,”
  2. (2003). A l l e n ,D .A .H e i m a n s o h n ,R .J .R o b i s o n ,J .J .S c h i e r
  3. (2002). a m m ,G .J u c h e m ,S .M i l z ,a n dB .R e i c h a r t ,“ C o n t i n u o u s graft perfusion: optimizing the quality of saphenous vein grafts,” The Heart Surgery Forum,v o l .5 ,s u p p l e m e n t4 ,p p .
  4. (1998). a n g ,F .Y .L i n ,C .H .T s a i ,a n dS .H .C h u , “Video-assisted endoscopic saphenous vein harvesting for coronary artery bypass grafting,”
  5. a o ,O .A z i z ,S .D e e b ae ta l . ,“ I sm i n i m a l l yi n v a s i v e harvesting of the great saphenous vein for coronary artery bypass surgery a cost-effective technique?”
  6. (2002). A prospective randomizedtrialofendoscopicversusconventionalharvesting of the saphenous vein in coronary artery bypass surgery,”
  7. (1999). A randomized trial of endoscopic versus open saphenous vein harvest in coronary bypass surgery,”
  8. (2000). A retrospective comparative study ofopen andendoscopicsaphenousveinharvesting,”
  9. (2007). a s s o ,A .A n s e l m i ,C .M .D eF i l i p p oe ta l . ,“ E v a l u a t i o no f less invasive method for saphenous vein harvest in patients with type II diabetes,”
  10. a v i s ,H .K .J a c o b s ,M .Z h a n g ,C .T h o m a s ,a n dY . Castellanos, “Endoscopic vein harvest for coronary artery bypass grafting: technique and outcomes,”
  11. (2004). Are wound healing disturbances and length of hospital stay reduced with minimally invasive vein harvest? A meta-analysis,”
  12. (2008). b b a s z a d e h ,M .K .A r a b n i a ,A .R a b b a n i ,M .H .M a n d e g a r
  13. (2008). C h i u ,C .L .C h e n ,S .H .C h u ,a n dT .Y .L i n ,“ E n d o s c o p i c harvest of saphenous vein: a lesson learned from 1,348
  14. (1999). C r o u c h ,D .P .O ’ H a i r ,J .P .K e u l e r ,T .P .B a r r a g r y
  15. (2004). Early quantitative coronary angiography of saphenous vein grafts for coronary artery bypass grafting harvested by means of open versus endoscopic saphenectomy: a prospective randomized trial,”
  16. (2002). Endoscopic saphenous vein harvesting for CABG—a randomized, prospective trial,”
  17. (1999). Endoscopic versus open saphenous vein harvest: the effect on postoperative outcomes,”
  18. (2008). Endoscopic vs open saphenous vein harvest for coronary artery bypass grafting: a prospective randomized trial,”
  19. (2002). F e l i s k y ,D .L .P a u l l ,M .E .H i l le ta l . ,“ E n d o s c o p i cg r e a t e r saphenous vein harvesting reduces the morbidity of coronary artery bypass surgery,”
  20. (1998). Griffit h ,D .A .H e i m a n s o h ne ta l . ,“ E n d o -scopicversustraditionalsaphenousveinharvesting:aprospective, randomized trial,”
  21. (2010). Impact of endoscopic versus open saphenous vein harvest techniques on outcomes after coronary artery bypass grafting,”
  22. (2004). J.Graham,andS.W.MacGowan,“Endoscopic vein harvest: advantages and limitations,”
  23. (2006). L e i s s n e r ,A .W o o ,R .O r t e g a ,a n dG .D .S t a n l e y , “Endoscopic saphenous vein harvest: severe hypercarbia,”
  24. (2009). L o p e s ,G .E .H a fl e y ,K .B .A l l e ne ta l . ,“ E n d o s c o p i cv e r s u s open vein-graft harvesting in coronary-artery bypass surgery,” New England
  25. (2003). Leg wound infection after coronary artery bypass grafting: a metaanalysis comparing minimally invasive versus conventional vein harvesting,” Annals of Thoracic Surgery,v o l .7 6 ,n o .6 ,p p .
  26. (2004). Long-term patency of coronary grafts with endoscopically harvested saphenous veins determined by contrast-enhanced electron beam computed tomography,”
  27. (2010). Mid-term outcomes for EndoscopicversusOpen VeinHarvest:a casecontrolstudy,”
  28. (2006). Minimally invasive conduit harvesting: a systematic review,”
  29. (1999). o p p o o l s e ,W .R e e s ,R .K r e c h ,M .H u f n a g e l ,K .S e u f e r t
  30. (2003). Prevalence of 90-days postoperative wound infections after cardiac surgery,”
  31. (2001). Prospective analysis of endoscopic vein harvesting,”
  32. (2009). R o u s o u ,K .B .T a y l o r ,X .G .L ue ta l . ,“ S a p h e n o u sv e i n conduits harvested by endoscopictechnique exhibit structural and functional damage,”
  33. Randomized trial of endoscopic versus open vein harvest for coronary artery bypass grafting: six-month patency rates,”
  34. (2000). Risk factors for leg wound complications following endoscopic versus traditional saphenous vein harvesting,” The heart surgery forum,
  35. (2007). Strategies to reduce intraluminal clot formation in endoscopically harvested saphenous veins,”
  36. (2008). V a i d y a n a t h a n ,M .N .S a n k a r ,a n dK .M .C h e r i a n , “Endoscopic vs conventional vein harvesting: a prospective analysis,” Asian Cardiovascular and Thoracic Annals,