OBJECTIVE: To evaluate angiographic and clinical outcomes associated with open and closed dissection tunnelendoscopic vein harvesting (EVH) devices. BACKGROUND: A previous PREVENT-IV (PRoject of Ex-vivo Vein graft ENgineering via Transfection IV) analysis reported that EVH for coronary artery bypass graft surgery was associated with worse outcomes than with traditional vein harvesting; however, outcomes by EVH device type were not available. METHODS: Using data from the PREVENT-IV trial, we compared 1549 patients from 75 surgical sites who underwent EVH with open (n = 390) or closed (n = 1159) harvest tunnel devices. Outcomes included the incidence of vein graft failure at 12 to 18 months and a composite of death, myocardial infarction, and revascularization through 5 years. RESULTS: Among patients undergoing open and closed tunnel EVH, no difference in the per-patient incidence of vein graft failure (43.8% vs 47.1%; adjusted odds ratio, 0.91; 95% confidence interval, 0.53-1.55; P = 0.724) or per-graft incidence of vein graft failure (25.5% vs 25.9%; adjusted odds ratio, 0.96; 95% confidence interval, 0.59-1.55; P = 0.847) was observed. At 5 years, no difference was observed in the primary composite clinical outcome between patients who underwent open and closed system EVH (21.5% vs 23.9%; adjusted hazard ratio, 0.85; 95% confidence interval, 0.66-1.10; P = 0.221). CONCLUSIONS: No differences in angiographic or clinical outcomes were observed among patients who underwent open versus closed tunnel endoscopic harvesting for coronary bypass surgery. These findings suggest that the risks associated with EVH that were reported in a previous PREVENT-IV analysis are not related to a specific EVH device.
RCT Entities:
OBJECTIVE: To evaluate angiographic and clinical outcomes associated with open and closed dissection tunnel endoscopic vein harvesting (EVH) devices. BACKGROUND: A previous PREVENT-IV (PRoject of Ex-vivo Vein graft ENgineering via Transfection IV) analysis reported that EVH for coronary artery bypass graft surgery was associated with worse outcomes than with traditional vein harvesting; however, outcomes by EVH device type were not available. METHODS: Using data from the PREVENT-IV trial, we compared 1549 patients from 75 surgical sites who underwent EVH with open (n = 390) or closed (n = 1159) harvest tunnel devices. Outcomes included the incidence of vein graft failure at 12 to 18 months and a composite of death, myocardial infarction, and revascularization through 5 years. RESULTS: Among patients undergoing open and closed tunnel EVH, no difference in the per-patient incidence of vein graft failure (43.8% vs 47.1%; adjusted odds ratio, 0.91; 95% confidence interval, 0.53-1.55; P = 0.724) or per-graft incidence of vein graft failure (25.5% vs 25.9%; adjusted odds ratio, 0.96; 95% confidence interval, 0.59-1.55; P = 0.847) was observed. At 5 years, no difference was observed in the primary composite clinical outcome between patients who underwent open and closed system EVH (21.5% vs 23.9%; adjusted hazard ratio, 0.85; 95% confidence interval, 0.66-1.10; P = 0.221). CONCLUSIONS: No differences in angiographic or clinical outcomes were observed among patients who underwent open versus closed tunnel endoscopic harvesting for coronary bypass surgery. These findings suggest that the risks associated with EVH that were reported in a previous PREVENT-IV analysis are not related to a specific EVH device.
Authors: Keith Allen; Davy Cheng; William Cohn; Mark Connolly; James Edgerton; Volkmar Falk; Janet Martin; Toshiya Ohtsuka; Richard Vitali Journal: Innovations (Phila) Date: 2005
Authors: Lawrence J Dacey; John H Braxton; Robert S Kramer; Joseph D Schmoker; David C Charlesworth; Robert E Helm; Carmine Frumiento; Gerald L Sardella; Robert A Clough; Stephan R Jones; David J Malenka; Elaine M Olmstead; Cathy S Ross; Gerald T O'Connor; Donald S Likosky Journal: Circulation Date: 2011-01-03 Impact factor: 29.690
Authors: John H Alexander; T Bruce Ferguson; Diane M Joseph; Michael J Mack; Randall K Wolf; C Michael Gibson; Daniel Gennevois; Todd J Lorenz; Robert A Harrington; Eric D Peterson; Kerry L Lee; Robert M Califf; Nicholas T Kouchoukos Journal: Am Heart J Date: 2005-10 Impact factor: 4.749
Authors: Emile N Brown; Zachary N Kon; Richard Tran; Nicholas S Burris; Junyen Gu; Patrick Laird; Philip S Brazio; Seeta Kallam; Kimberly Schwartz; Lisa Bechtel; Ashish Joshi; Shaosong Zhang; Robert S Poston Journal: J Thorac Cardiovasc Surg Date: 2007-09-29 Impact factor: 5.209
Authors: U P Schurr; M L Lachat; O Reuthebuch; A Kadner; M Mäder; B Seiffert; S P Hoerstrup; G Zünd; M Genoni; M I Turina Journal: Thorac Cardiovasc Surg Date: 2002-06 Impact factor: 1.827
Authors: Renato D Lopes; Judson B Williams; Rajendra H Mehta; Eric M Reyes; Gail E Hafley; Keith B Allen; Michael J Mack; Eric D Peterson; Robert A Harrington; C Michael Gibson; Robert M Califf; Nicholas T Kouchoukos; T Bruce Ferguson; Todd J Lorenz; John H Alexander Journal: Am Heart J Date: 2012-09 Impact factor: 4.749
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: Margreet R de Vries; Karin H Simons; J Wouter Jukema; Jerry Braun; Paul H A Quax Journal: Nat Rev Cardiol Date: 2016-05-19 Impact factor: 32.419
Authors: Connie N Hess; Renato D Lopes; C Michael Gibson; Rebecca Hager; Daniel M Wojdyla; Brian R Englum; Michael J Mack; Nicholas T Kouchoukos; Eric D Peterson; John H Alexander Journal: Circulation Date: 2015-07-28 Impact factor: 29.690
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: Bhuvaneswari Krishnamoorthy; William R Critchley; Alexander J Thompson; Katherine Payne; Julie Morris; Rajamiyer V Venkateswaran; Ann L Caress; James E Fildes; Nizar Yonan Journal: Circulation Date: 2017-06-21 Impact factor: 29.690