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



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.


Allen KB, Cheng D, Cohn W 2005. Endoscopic vascular harvest in coronary artery bypass grafting surgery: a consensus statement of the International Society of Minimally Invasive Cardiothoracic Surgery (ISMICS) 2005. Innovations (Phila) 1:51-60.nAllen KB, Griffith GL, Heimansohn DA 1998. Endoscopic versus traditional saphenous vein harvesting: a prospective, randomized trial. Ann Thorac Surg 66:26-31.nBrown EN, Kon ZN, Tran R, Burris NS 2007. Strategies to reduce intraluminal clot formation in endoscopically harvested saphenous veins. J Thorac Cardiovasc Surg 134:1259-65.nEagle KA, Guyton RA, Davidoff R 2004. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for Coronary Artery Bypass Graft Surgery). Circulation 110:1168-76 [erratum, Circulation 111:2014].nHigami T, Kozawa S, Asada T, Shida T, Ogawa K. 2000. Skeletonization and harvest of the internal thoracic artery with an ultrasonic scalpel. Ann Thorac Surg 70:307-8.nHigami T, Maruo A, Yamashita T, Shida T, Ogawa K. 2000. Histologic and physiologic evaluation of skeletonized internal thoracic artery harvesting with an ultrasonic scalpel. J Thorac Cardiovasc Surg 120:1142-7.nLopes RD, Hafley GE, Allen KB 2009. Endoscopic versus open vein-graft harvesting in cononary-artery bypass surgery. N Engl J Med 361:235-44.nLumsden AB, Eaves FF 3rd, Ofenloch JC, Jordan WD. 1996. Subcutaneous, video-assisted saphenous vein harvest: report of the first 30 cases. Cardiovasc Surg 4:771-6.nNickum CW. 2005. Endoscopic vessel harvesting in coronary artery bypass graft surgery. JAAPA 18:40, 42, 44, 51-3.nRang HP, Dale MM, Ritter JM, Gardner P. 1995. Hemostasis and thrombosis. In: Pharmacology. New York, NY: Churchill Livingstone. p 331-50.nRousou LJ, Taylor KB, Lu XG 2009. Saphenous vein conduits harvested by endoscopic technique exhibit structural and functional damage. Ann Thorac Surg 87:62-70.nSellke FW, Boyle EM Jr, Verrier ED. 1997. The pathophysiology of vasomotor dysfunction. Ann Thorac Surg 64:S9-15.nVaidyanathan KR, Sankar MN, Cherian KM. 2008. Endoscopic vs conventional vein harvesting: a prospective analysis. Asian Cardiovasc Thorac Ann 16:134-8.nVerrier ED, Boyle EM. 1997. Endothelial cell injury in cardiovascular surgery: an overview. Ann Thorac Surg 64:S2-8.nZilla P, von Oppell U, Deutsch M. 1993. The endothelium: a key to the future. J Card Surg 8:32-60.n



How to Cite

Wang, H., Wu, H., Jiang, H., Wang, Z., Potapov, E., & Stepanenko, A. (2011). Initial Experience with Endoscopic Saphenous Vein Harvesting for Coronary Artery Bypass Graft ing in Chinese Patients. The Heart Surgery Forum, 14(5), E291-E296.