Cor Vasa 2014, 56(3):e240-e245 | DOI: 10.1016/j.crvasa.2014.04.006

Midterm patency and risk factors for vein graft occlusion after endoscopic harvest

Vojtěch Kurfirst^a,c,*, Júlia Čanádyová^a, Jiří Kubále^b, Petr Lhoták^b, Aleš Mokráček^a,c

^a Kardiochirurgické oddělení, Nemocnice České Budějovice, a. s., České Budějovice, Česká republika

^b Radiologické oddělení, Nemocnice České Budějovice, a. s., České Budějovice, Česká republika

^c Zdravotně sociální fakulta, Jihočeská univerzita, České Budějovice, Česká republika

Objectives: To evaluate midterm patency of saphenous vein grafts harvested endoscopically and identify risk factors for subsequent vein graft occlusion.

Methods: Fifty consecutive patients undergoing coronary artery bypass surgery with venous graft harvested by endoscopic method were included in the study. Patients underwent computed tomography angiography follow--up at mean 24 months. Multivariate logistic regression was used to analyze associations between preoperative variables (age, ejection fraction, body mass index, gender, hyperlipidemia, hypertension, diabetes mellitus, smoking, number of defects per graft and target vessel stenosis) and the incidence of saphenous vein graft occlusion.

Results: Occlusion of the saphenous vein graft occurred in 7 patients (14.3%) and occlusion of the left internal mammary artery graft in 1 patient (2.3%) during the 24 months after surgery. No significant stenosis (i.e. narrowing by >50%) was found in the remaining grafts. Multivariate logistic regression found no association between preoperative variables and saphenous vein graft occlusion.

Conclusions: Patency rates 2 years after endoscopic vein harvesting are comparable to those from open techniques. Our data indicated no association between preoperative variables and vein graft occlusion. These results support the use of endoscopic saphenectomy in a wide spectrum of patients undergoing coronary artery bypass surgery.

Keywords: Endoscopic harvest; Graft patency; Saphenous vein

Received: April 5, 2014; Revised: April 28, 2014; Accepted: April 29, 2014; Published: June 1, 2014  Show citation