Cor Vasa 2011, 53(6-7):333-339 | DOI: 10.33678/cor.2011.083

Endoscopic vein harvesting for coronary artery bypass grafting. Five-year single centre experience

Martin Šimek^1,*, Marek Gwozdziewicz¹, Pavel Marcián¹, Kateřina Langová², Petr Šantavý¹, Andrea Steriovský¹, Ivo Fluger¹, Vladimír Lonský¹

¹ Kardiochirurgická klinika, Fakultní nemocnice Olomouc a Lékařská fakulta Univerzity Palackého

² Ústav lékařské biofyziky, Lékařská fakulta Univerzity Palackého, Olomouc, Česká republika

Aim: To determine the outcome of endoscopic vein harvesting for CABG and impact of growing experience with method on its performance.

Methods: From September 2005 to September 2010, endoscopic vein harvesting was carried out in the group of 400 elective patients.
Demographic, perioperative, and outcome data was followed-up prospectively to assess impact of growing experience on the results of the method. Furthermore, univariable analysis focused on impact of wound-healing complication risk factors was added.

Results: Mean age was 68.9 ± 8.5 years, men dominated over women (69 vs. 31%), and mean BMI reached 31.1 ± 4.1. The mean number of 2.1 ± 0.8 venous grafts was harvested in total mean length 34.4 ± 9.6 cm and the mean total vein harvesting time reached 41.8 ± 10.4 min.
In seven cases (1.8%), endoscopic vein harvest needed to be converted. In the postoperative period, the presence of wound haematoma was noted in 33% of harvest, residual leg edema in 12%, 7.8 % of patients complained of mild lower leg pain and 5.3% of saphenous neuropathy. No wound healing disturbances were found, transient lymphatic discharge was recorded in 1.2% of cases. During 3-month follow-up, the incidence of residual edema, pain, and saphenous neuropathy decreased to 5%, 4%, and 3.2%, respectively. Multivariable analysis did not reveal any correlation between the presence of wound-healing risk factors and post-harvesting complications. Improvements in performance led to significant increase of graft length/harvesting time ratio and decrease in post-harvesting complications.

Conclusion: Outcome of endoscopic vein harvesting is closely related to the experience with the method; in addition, the pre-operative presence of wound-healing risk factors has no influence on post-harvesting complication rate.

Keywords: Vein harvesting; Endoscopic harvesting; CABG

Published: June 1, 2011  Show citation