Early Results of Endoscopic Saphenous Vein Harvesting in Coronary Artery Bypass Grafting
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(Department of Cardiovascular Surgery, Fukui Cardiovascular Center, Fukui, Japan)
Hiroyuki Seo |
Yasushi Tsutsumi |
Osamu Monta |
Satoshi Numata |
Sachiko Yamazaki |
Shohei Yoshida |
Hirokazu Ohashi |
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Recently, with the advent of medical devices and minimally invasive operations, endoscopic saphenous vein harvesting(EVH)in coronary artery bypass grafting has been widely accepted. Although EVH has short-term advantages of less wound morbidity and better cosmetic results compared with open vein harvesting(OVH), several studies have demonstrated that the mid- and long-term patency rate of EVH veins is significantly lower than that of OVH veins, therefore the role of EVH is currently controversial. The purpose of this study was to investigate the early results of EVH compared with the OVH group. Between April 2011 and December 2012, 115 consecutive patients underwent coronary artery bypass grafting(CABG)in our institution. Of these, EVH was performed in 62 patients and OVH in 53. In EVH groups, all 50 patients were men, and mean age was 71.3±7.8 years. A total of 211 coronary anastomoses, 109 SVGs anastomoses were assessed for patency postoperatively by angiography or enhanced computed tomography before discharge. The mean vein harvesting time was 26.0±8.1 min, and the mean number of ostial branch tear was 0.34±0.59. The overall SVG patency rates at discharge were 95.4% in EVH and 92% in OVH, respectively(p=0.24). There was a significant reduction in the incidence of leg wound complications in the EVH group(EVH:1.6%;OVH:13.2%;p=0.038). In conclusion, the short-term result of EVH was satisfactory. EVH reduces leg wound complications compared with OVH.
Jpn. J. Cardiovasc. Surg. 42:364-368(2013)
Keywords:CABG, SVG, endoscopic vein harvesting, graft patency rate, wound complication
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