Cor Vasa 2006, 48(12):427-432 | DOI: 10.33678/cor.2006.136

Endoscopic saphenous vein harvesting for coronary artery bypass grafting. Postoperative and mid-term outcome in a group of 100 patients

Martin Šimek, Vilém Bruk, Petr Němec

Kardiochirurgická klinika, Fakultní nemocnice Olomouc a Lékařská fakulta Univerzity Palackého, Olomouc, Česká republika

Background:
Traditional great saphenous vein harvesting for coronary artery bypass grafting is associated with a significant risk of impaired wound healing. Endoscopic saphenous vein harvesting (EVH) has been introduced in an effort to reduce the incidence of leg wound complications, whereas the histological quality and long-term patency of harvested grafts are comparable with those of grafts harvested using the traditional technique.

Methods:
From July 2005 through March 2006, EVH was performed, using the Vasoview 6™ system (Guidant Europe S. A., Belgium), in a group of 100 patients. Patients were evaluated for impaired wound healing, residual leg edema and saphenous vein neuropathy on postoperative day 7 and at 3 months after the procedure.

Results:
The mean age was 68.9 ± 10.2 years, with male patients prevailing (68%). At least one independent risk factor of impaired leg wound healing such as obesity, diabetes, peripheral vascular disease and female gender was present in 67 patients (67%). The mean number of harvested venous grafts was 2.2 ± 1.2 and mean total vein harvesting time was 40.2 ± 8.3 minutes. The traditional harvesting technique was used instead of EVH in two cases (2%). The presence of wound hematoma was noted in 46 patients (46%). No early complications such as wound infection, dehiscence, skin necrosis, and lymphatic drainage were observed. The incidence of residual leg edema decreased from 15% to 7% during 3-month follow-up. Likewise, the incidence of saphenous neuropathy decreased from 6% to 2%.

Conclusion:
The procedure significantly reduces the morbidity associated with great saphenous vein harvesting. It does not prolong operative time and carries a low risk of periprocedural complications. Endoscopic saphenous vein harvesting should become a standard method of care, particularly for patients with risk factors for leg wound complications such as diabetes mellitus, peripheral artery disease, obesity or prolonged immunosuppressive therapy. The quality of grafts and harvesting time were comparable to those reporting for grafts harvested using the traditional harvesting technique.

Keywords: Endoscopic saphenous vein harvesting; Vein harvesting; CABG; Vasoview 6™

Published: December 1, 2006  Show citation