Full Text:   <3212>

CLC number: R54

On-line Access: 

Received: 2009-07-15

Revision Accepted: 2009-08-13

Crosschecked: 2009-08-26

Cited: 2

Clicked: 6168

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
1. Reference List
Open peer comments

Journal of Zhejiang University SCIENCE B 2009 Vol.10 No.10 P.748-752

http://doi.org/10.1631/jzus.B0940010


Endoscopic vein harvest in elective off-pump coronary artery bypass grafting


Author(s):  Nai-kuan CHOU, Meng-lin LEE, Shoei-shen WANG

Affiliation(s):  Division of Cardiovascular Surgery, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei City

Corresponding email(s):   wangp@ntu.edu.tw

Key Words:  Endoscopic vein harvest (EVH), Open vein harvest (OVH), Off-pump coronary artery bypass grafting, Greater saphenous vein (GSV), Internal mammary artery (IMA)


Nai-kuan CHOU, Meng-lin LEE, Shoei-shen WANG. Endoscopic vein harvest in elective off-pump coronary artery bypass grafting[J]. Journal of Zhejiang University Science B, 2009, 10(10): 748-752.

@article{title="Endoscopic vein harvest in elective off-pump coronary artery bypass grafting",
author="Nai-kuan CHOU, Meng-lin LEE, Shoei-shen WANG",
journal="Journal of Zhejiang University Science B",
volume="10",
number="10",
pages="748-752",
year="2009",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B0940010"
}

%0 Journal Article
%T Endoscopic vein harvest in elective off-pump coronary artery bypass grafting
%A Nai-kuan CHOU
%A Meng-lin LEE
%A Shoei-shen WANG
%J Journal of Zhejiang University SCIENCE B
%V 10
%N 10
%P 748-752
%@ 1673-1581
%D 2009
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B0940010

TY - JOUR
T1 - Endoscopic vein harvest in elective off-pump coronary artery bypass grafting
A1 - Nai-kuan CHOU
A1 - Meng-lin LEE
A1 - Shoei-shen WANG
J0 - Journal of Zhejiang University Science B
VL - 10
IS - 10
SP - 748
EP - 752
%@ 1673-1581
Y1 - 2009
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B0940010


Abstract: 
While traditional open vein harvest was related to postoperative wound complications, endoscopic vein harvest was developed to minimize the morbidity in the greater saphenous vein harvest procedure. In this study, these two procedures were compared for postoperative wound healing and long-term graft patency. We reviewed all consecutive patients undergoing elective off-pump coronary artery bypass grafting from January 2004 to December 2005 and collected data regarding wound complications and coronary events. Wound complications included dehiscence, excessive discharge, edema, altered sensation, cellulitis, hematoma, pain scale, and superficial and deep wound infection. Coronary events were defined as diagnosis of myocardial infarction during the first year’s follow-up. A total of 392 patients were included in our series, among whom 44 were excluded from the study due to emergent operation, preoperative intra-aortic balloon pump support, or the greater saphenous vein varicose characteristic, 78 belonged to open vein harvest group, and 270 to endoscopic vein harvest group. Wound complications were significantly less in the endoscopic group (5.2%) compared to the open group (19.2%) (P=0.0002). There was no significant difference on preoperative risk factors, total operative time, or hospitalization days. During one-year follow-up, both the early and late graft patency rates were similar between the two groups. Endoscopic vein harvest is safe and effective, which carries less risk for wound complications and is associated with better satisfaction and cosmetic result than the traditional greater saphenous vein harvest procedure. The endoscopic vein harvest also demonstrates a great long-term patency.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1] Allen, K.B., Griffith, G.L., Heimansohn, D.A., Robison, R.J., Matheny, R.G., Schier, J.J., Fitzgerald, E.B., Shaar, C.J., 1998. Endoscopic versus traditional saphenous vein harvesting: a prospective randomized trial. Ann. Thorac. Surg., 66(1):26-31.

[2] Bonde, P., Graham, A.N., MacGowan, S.W., 2004. Endoscopic vein harvest: advantages and limitation. Ann. Thorac. Surg., 77(6):2076-2082.

[3] Chiu, K.M., Lin, T.Y., Wang, M.J., Chu, S.H., 2006. Reduction of carbon dioxide embolism for endoscopic saphenous vein harvesting. Ann. Thorac. Surg., 81(5): 1697-1699.

[4] Delaria, G.A., Hunter, J.A., Goldin, M.D., Serry, C., Javid, H., Najafi, H., 1981. Leg wound complications with coronary revascularization. J. Thorac. Cardiovasc. Surg., 81(3): 403-407.

[5] Graceley, R., 1986. Verbal Pain Assessment: Integrated Approach to Management of Pain. National Institutes of Health Consensus Development Conference. February 4, 1986, Baltimore.

[6] Kiaii, B., Moon, B.C., Massel, D., Langlois, Y., Austin, T.W., Willoughby, A., Guiraudon, C., Howard, C.R., Guo, L.R., 2002. A prospective randomized trial of endoscopic versus conventional harvesting of the saphenous vein in coronary artery bypass surgery. J. Thorac. Cardiovasc. Surg., 123(2):204-212.

[7] Lopes, R.D., Hafley, G.E., Allen, K.B., Ferguson, T.B., Peterson, E.D., Harrington, R.A., Mehta, R.H., Gibson, C.M., Mack, M.J., Kouchoukos, N.T., Califf, R.M., Alexander, J.H., 2009. Endoscopic versus open vein-graft harvesting in coronary-artery bypass surgery. N. Engl. J. Med., 361(3):235-244.

[8] Luh, S.P., Liu, H.P., 2006. Video-assisted thoracic surgery: the past, present status and the future. J. Zhejiang Univ. Sci. B, 7(2):118-128.

[9] Lumsden, A.B., Eaves III, F.F., Ofenloch, J.C., Jordan, W.D., 1996. Subcutaneous, video-assisted saphenous vein harvest: report of the first 30 cases. Cardiovasc. Surg., 4(6):771-776.

[10] Marty, B., von Segesser, L.K., Tozzi, P., Guzmann, J., Frascarolo, P., Muller, X., Hayoz, D., 2000. Benefits of endoscopic vein harvesting. World J. Surg., 24(9): 1104-1108.

[11] McGuire, D.B., 1984. The measurement of clinical pain. Nursing Res., 33(3):152-156.

[12] Utley, J.R., Thomason, M.E., Wallace, D.J., Mutch, D.W., Staton, L., Brown, V., Wilde, C.M., Bell, M.S., 1989. Preoperative correlates of impaired wound healing after saphenous vein excision. J. Thorac. Cardiovasc. Surg., 98(1):147-149.

[13] Wilson, A.P., Weavill, C., Burridge, J., Kelsey, M.C., 1990. The use of the wound scoring method ‘ASEPSIS’ in postoperative wound surveillance. J. Hosp. Infect., 16(4): 297-309.

Open peer comments: Debate/Discuss/Question/Opinion

<1>

Please provide your name, email address and a comment





Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2024 Journal of Zhejiang University-SCIENCE