BACKGROUND: Endoscopic saphenous vein harvest (EVH) decreases leg wound infections and improves cosmesis after coronary artery bypass grafting (CABG). Recent data, however, suggest that EVH may be associated with reduced graft patency rates. The objective of this study is to assess the effect of EVH on short-term and midterm outcomes after CABG. METHODS: Data were prospectively collected on all first-time isolated CABG and combined valve/CABG with saphenous vein graft between 1998 and 2007 at a single center. Patients having traditional "open" vein harvest (OVH) were compared with patients having EVH. Multivariate models were used to examine the risk-adjusted impact of EVH on postoperative leg infection, composite in-hospital adverse events, and individual and composite midterm adverse events. RESULTS: The study included 5,825 patients, of whom 2,004 (34.4%) had EVH. Patients having EVH were more likely to have ejection fraction less than 50% (32.0% versus 29.3%, p = 0.04), recent myocardial infarction (24.2% versus 18.3%, p < 0.0001), and left main disease (26.0% versus 22.1%, p = 0.0009). Median follow-up was 2.6 years. After risk adjustment, EVH was associated with reduced rates of leg infection (odds ratio 0.48, p = 0.003) but had no association with either in-hospital (odds ratio 0.93, p = 0.56) or midterm adverse outcomes (hazard ratio 0.93, p = 0.22). Endoscopic saphenous vein harvest was associated with reduced readmission to hospital for unstable angina (odds ratio 0.74, p = 0.01). CONCLUSIONS: Endoscopic saphenous vein harvest is associated with a lower rate of leg infection and is not an independent predictor of in-hospital or midterm adverse outcomes. Endoscopic saphenous vein harvest is a safe alternative to OVH for patients undergoing CABG with saphenous vein. 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
BACKGROUND: Endoscopic saphenous vein harvest (EVH) decreases leg wound infections and improves cosmesis after coronary artery bypass grafting (CABG). Recent data, however, suggest that EVH may be associated with reduced graft patency rates. The objective of this study is to assess the effect of EVH on short-term and midterm outcomes after CABG. METHODS: Data were prospectively collected on all first-time isolated CABG and combined valve/CABG with saphenous vein graft between 1998 and 2007 at a single center. Patients having traditional "open" vein harvest (OVH) were compared with patients having EVH. Multivariate models were used to examine the risk-adjusted impact of EVH on postoperative leg infection, composite in-hospital adverse events, and individual and composite midterm adverse events. RESULTS: The study included 5,825 patients, of whom 2,004 (34.4%) had EVH. Patients having EVH were more likely to have ejection fraction less than 50% (32.0% versus 29.3%, p = 0.04), recent myocardial infarction (24.2% versus 18.3%, p < 0.0001), and left main disease (26.0% versus 22.1%, p = 0.0009). Median follow-up was 2.6 years. After risk adjustment, EVH was associated with reduced rates of leg infection (odds ratio 0.48, p = 0.003) but had no association with either in-hospital (odds ratio 0.93, p = 0.56) or midterm adverse outcomes (hazard ratio 0.93, p = 0.22). Endoscopic saphenous vein harvest was associated with reduced readmission to hospital for unstable angina (odds ratio 0.74, p = 0.01). CONCLUSIONS: Endoscopic saphenous vein harvest is associated with a lower rate of leg infection and is not an independent predictor of in-hospital or midterm adverse outcomes. Endoscopic saphenous vein harvest is a safe alternative to OVH for patients undergoing CABG with saphenous vein. 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Authors: Brian C Gulack; Katherine A Kirkwood; Wei Shi; Peter K Smith; John H Alexander; Sandra G Burks; Annetine C Gelijns; Vinod H Thourani; Daniel Bell; Ann Greenberg; Seth D Goldfarb; Mary Lou Mayer; Michael E Bowdish Journal: J Thorac Cardiovasc Surg Date: 2017-12-06 Impact factor: 5.209
Authors: Bhuvaneswari Krishnamoorthy; William R Critchley; Alex T Glover; Janesh Nair; Mark T Jones; Paul D Waterworth; James E Fildes; Nizar Yonan Journal: Interact Cardiovasc Thorac Surg Date: 2012-05-18
Authors: Sean van Diepen; J Matthew Brennan; Gail E Hafley; Eric M Reyes; Keith B Allen; T Bruce Ferguson; Eric D Peterson; Judson B Williams; C Michael Gibson; Michael J Mack; Nicholas T Kouchoukos; John H Alexander; Renato D Lopes Journal: Ann Surg Date: 2014-08 Impact factor: 12.969
Authors: Martin Andreas; Dominik Wiedemann; Sebastian Stasek; Stephanie Kampf; Marek Ehrlich; Ernst Eigenbauer; Guenther Laufer; Alfred Kocher Journal: Interact Cardiovasc Thorac Surg Date: 2013-06-30
Authors: Judson B Williams; Eric D Peterson; J Matthew Brennan; Art Sedrakyan; Dale Tavris; John H Alexander; Renato D Lopes; Rachel S Dokholyan; Yue Zhao; Sean M O'Brien; Robert E Michler; Vinod H Thourani; Fred H Edwards; Hesha Duggirala; Thomas Gross; Danica Marinac-Dabic; Peter K Smith Journal: JAMA Date: 2012-08-01 Impact factor: 56.272
Authors: Karishma Kodia; Sinal Patel; Matthew P Weber; Jessica G Y Luc; Jae Hwan Choi; Elizabeth J Maynes; Syed-Saif Abbas Rizvi; Dylan P Horan; H Todd Massey; John W Entwistle; Rohinton J Morris; Vakhtang Tchantchaleishvili Journal: Ann Cardiothorac Surg Date: 2018-09
Authors: J Fassl; H Riha; H Ramakrishna; N Singh; T Wyckoff; C Roscher; J G T Augoustides Journal: HSR Proc Intensive Care Cardiovasc Anesth Date: 2010