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Initial Experience with Endoscopic Saphenous Vein Harvesting for Coronary Artery Bypass Graft ing in Chinese Patients

Huishan Wang, Haibo Wu, Hui Jiang, Zengwei Wang, Evginij Potapov, Alexander Stepanenko

Abstract


Objective: We aimed to investigate the initial experience of endoscopic vein harvesting (EVH) for coronary artery bypass grafting (CABG) in Chinese patients.

Methods: Forty patients scheduled for isolated CABG were prospectively randomized into an EVH group (n = 20) and an open vein harvesting (OVH) group (n = 20). Clinical data were collected, and all of the vein grafts were assessed by macroscopic appearance, histologic quality (endothelial integrity), and functional characteristics of endothelial nitric oxide synthase.

Results: The 2 groups were similar with respect to hospital mortality (EVH group, 0; OVH group, 1; P = 1). There were no postoperative myocardial infarctions in either group and no deaths or reinterventions in either group during the follow-up period. Harvesting times in the 2 groups were similar (EVH, 12.15 2.32 min; OVH, 12.55 2.11 min; P = .571). Three patients in the EVH group were converted to a partly open or skin-bridge technique. Electrocautery at least 2 mm distal to the origin of the side branch was the safety margin.

Conclusions: The use of EVH in Chinese patients was not related to adverse events and may be safely used for CABG procedures. Preoperative duplex mapping, systemic heparinization before harvesting, minimal surgical manipulation, and sectioning of side branches at least 2 mm distal to the origin may help improve the quality of vein grafts harvested with EVH and maximize the benefit of this less-invasive technique.


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DOI: http://dx.doi.org/10.1532/HSF98.20111035

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