Endoscopic Versus "No-Touch" Saphenous Vein Harvesting for Coronary Artery Bypass Grafting: A Trade-Off Between Wound Healing and Graft Patency.
The advantage in terms of wound infection, wound healing, and scarring has resulted in the recent adoption of endoscopic vein harvesting (EVH) as a standard of care for coronary artery bypass grafting in some centers. However, concerns regarding the quality of these grafts have been raised after recent evidence of decreased graft patency, increased reoperation rate, and myocardial infarct, problems that are associated with vascular trauma caused when using this technique. Simultaneously, an atraumatic, "no-touch" technique for harvesting the saphenous vein was developed producing grafts with improved patency comparable to the internal thoracic artery. However, wound complications remain a problem using this technique. This review outlines the need to consider the poor graft quality that may result from EVH and raises the question what is likely to be the "best practice principle" in saphenous vein harvesting?
['Kopjar|Tomislav|T|', 'Dashwood|Michael R|MR|']
D001026:Coronary Artery Bypass D003324:Coronary Artery Disease D003362:Cost-Benefit Analysis D004724:Endoscopy D006083:Graft Occlusion, Vascular D017048:Health Care Costs D006801:Humans D012307:Risk Factors D012501:Saphenous Vein D013530:Surgical Wound Infection D020858:Tissue and Organ Harvesting D016896:Treatment Outcome D014654:Vascular Patency D014945:Wound Healing
coronary artery bypass grafting endoscopic vein harvesting no-touch vein harvesting saphenous vein patency vascular damage