B H Kirmani1, S Power1, J Zacharias1. 1. Blackpool Victoria Hospital, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK.
Abstract
INTRODUCTION: Endoscopic vein harvest is the technique of choice in North America, where it constitutes 80% of conduit harvest for coronary artery bypass grafting. The UK has much lower rates, despite demonstrable perioperative benefits. Concerns about patency and long-term survival are often cited as reasons for poor uptake and evidence in the literature thus far has only addressed mid-term outcomes. We sought to identify the long-term survival of patients undergoing endoscopic vein harvest compared with a contemporaneous cohort of open vein harvest. MATERIALS AND METHODS: This was a retrospective cohort study of all consecutive patients undergoing isolated coronary artery bypass grafting at a single institution between 2007 and 2017. All-cause long-term mortality was compared using Kaplan-Meier curves and log-rank analysis. RESULTS: A total of 7,527 patients undergoing coronary artery bypass grafting (1,029 receiving endoscopic vein harvest) were studied. The groups were well matched for preoperative characteristics, except that there were more patients with triple-vessel disease and good left-ventricular function in the endoscopic vein harvest group. There was no statistically significant difference in the long-term survival (p = 0.23). At five years (median follow-up), survival was 86.1% (95% confidence interval 85.3-87.0) in the open vein harvest group compared with 85.5% (95% confidence interval 82.8-88.2) in the endoscopic vein harvest group. DISCUSSION AND CONCLUSION: Endoscopic vein harvest does not affect long-term survival in an unselected population. The contraindications for minimally invasive vein harvest in coronary artery bypass grafting are increasingly diminishing.
INTRODUCTION: Endoscopic vein harvest is the technique of choice in North America, where it constitutes 80% of conduit harvest for coronary artery bypass grafting. The UK has much lower rates, despite demonstrable perioperative benefits. Concerns about patency and long-term survival are often cited as reasons for poor uptake and evidence in the literature thus far has only addressed mid-term outcomes. We sought to identify the long-term survival of patients undergoing endoscopic vein harvest compared with a contemporaneous cohort of open vein harvest. MATERIALS AND METHODS: This was a retrospective cohort study of all consecutive patients undergoing isolated coronary artery bypass grafting at a single institution between 2007 and 2017. All-cause long-term mortality was compared using Kaplan-Meier curves and log-rank analysis. RESULTS: A total of 7,527 patients undergoing coronary artery bypass grafting (1,029 receiving endoscopic vein harvest) were studied. The groups were well matched for preoperative characteristics, except that there were more patients with triple-vessel disease and good left-ventricular function in the endoscopic vein harvest group. There was no statistically significant difference in the long-term survival (p = 0.23). At five years (median follow-up), survival was 86.1% (95% confidence interval 85.3-87.0) in the open vein harvest group compared with 85.5% (95% confidence interval 82.8-88.2) in the endoscopic vein harvest group. DISCUSSION AND CONCLUSION: Endoscopic vein harvest does not affect long-term survival in an unselected population. The contraindications for minimally invasive vein harvest in coronary artery bypass grafting are increasingly diminishing.
Authors: Bob Kiaii; Byung C Moon; David Massel; Yves Langlois; Thomas W Austin; Andrea Willoughby; C Guiraudon; Craig R Howard; L Ray Guo Journal: J Thorac Cardiovasc Surg Date: 2002-02 Impact factor: 5.209
Authors: Pim A L Tonino; Bernard De Bruyne; Nico H J Pijls; Uwe Siebert; Fumiaki Ikeno; Marcel van' t Veer; Volker Klauss; Ganesh Manoharan; Thomas Engstrøm; Keith G Oldroyd; Peter N Ver Lee; Philip A MacCarthy; William F Fearon Journal: N Engl J Med Date: 2009-01-15 Impact factor: 91.245
Authors: Francis D Ferdinand; John K MacDonald; Husam H Balkhy; Gianluigi Bisleri; Ho Young Hwang; Patricia Northrup; Richard H J Trimlett; Lai Wei; Bob B Kiaii Journal: Innovations (Phila) Date: 2017 Sep/Oct
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: Bhuvaneswari Krishnamoorthy; Joesph Zacharias; William R Critchley; Melissa Rochon; Iryna Stalpinskaya; Azita Rajai; Rajamiyer V Venkateswaran; Shahzad G Raja; Toufan Bahrami Journal: NIHR Open Res Date: 2021-07-08