Absorption of carbon dioxide during endoscopic vein harvest

Zingaro, Carlo; Pierri, Michele D.; Massi, Francesco; Matteucci, Marco; Capestro, Filippo; D’Alfonso, Alessandro; Aratari, Carlo; Torracca, Lucia

doi:10.1093/icvts/ivs255

Cited by 6 publications

(4 citation statements)

References 15 publications

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“…With two articles identified by a manual search of references, finally, 40 articles from 34 RCTs were eligible for quantitative data syntheses. Two RCTs [28,29] which compared open EVH versus closed EVH were excluded from the main analysis. One RCT [23], which combined open EVH and closed EVH to compare with CVH, was excluded from the sensitivity analysis.…”

Section: Resultsmentioning

confidence: 99%

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Saphenous vein harvesting techniques for coronary artery bypass grafting: a systematic review and meta-analysis

Vuong¹,

Elfaituri²,

Eldoadoa³

et al. 2021

Coronary Artery Disease

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The great saphenous vein (GSV) graft remains a frequently used conduit for coronary artery bypass graft (CABG) surgery. The optimal technique for GSV harvesting has been the subject of on-going controversy. We therefore sought to conduct a systematic review and meta-analysis of all available GSV harvesting techniques in CABG. A systematic search of 12 electronic databases was performed to identify all randomized controlled trials (RCTs) of any GSV harvesting technique, including conventional vein harvesting (CVH), no-touch, standard bridging technique (SBT) and endoscopic vein harvesting (EVH) techniques. We investigated safety and long-term efficacy outcomes. All outcomes were analyzed using the frequentist network meta-analysis. A total of 6480 patients from 34 RCTs were included. For safety outcomes, EVH reduced 91% and 77% risk of wound infection compared to no-touch and CVH, respectively. EVH and SBT also significantly reduced the risk of sensibility disorder and postoperative pain. The techniques were not significantly different regarding long-term efficacy outcomes, including mortality, myocardial infarction and graft patency. For GSV harvesting for CABG, EVH techniques are the most favorable, but in case of using an open technique, no-touch is more recommended than CVH. More effective and safer procedures should be investigated for GSV harvesting in CABG.

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Section: Resultsmentioning

confidence: 99%

“…With two articles identified by a manual search of references, finally, 40 articles from 34 RCTs were eligible for quantitative data syntheses. Two RCTs[28,29] which compared open…”

mentioning

confidence: 99%

Saphenous vein harvesting techniques for coronary artery bypass grafting: a systematic review and meta-analysis

Vuong¹,

Elfaituri²,

Eldoadoa³

et al. 2021

Coronary Artery Disease

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“…There are further concerns regarding the creation of a carbon dioxide tunnel around the harvest conduit [26][27][28] and our previous study has demonstrated that there was no impact by the tunnel 29 .…”

Section: Discussionmentioning

confidence: 99%

A multicentre review comparing long term outcomes of endoscopic vein harvesting versus open vein harvesting for coronary artery bypass surgery

et al. 2021

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Background: Utilisation of the Endoscopic Vein Harvesting (EVH) technique has been increasing for coronary artery bypass grafting (CABG) for the last two decades. Some surgeons remain concerned about the long-term patency of the long saphenous vein harvested endoscopically compared to traditional Open Vein Harvesting (OVH). The aim of this study was to perform a retrospective analysis of the outcomes between EVH and OVH from three UK centres with 10 years follow-up. Methods: 27,024 patients underwent CABG with long saphenous vein harvested by EVH (n=13,794) or OVH (n=13,230) in three UK centres between 2007 and 2019. Propensity modelling was used to calculate the Inverse Probability of Treatment Weights (IPTW). The primary endpoint was mortality from all causes and secondary endpoints were length of hospital stay, postoperative complications, and incidence of repeat coronary re-vascularisation for symptomatic patients. IPTW was used to balance the two intervention groups for baseline and preoperative co-morbidities. Results: Median follow-up time was 4.54 years for EVH and 6.00 years for OVH. Death from any cause occurred in 13.8% of the EVH group versus 20.8% in the OVH group over the follow-up period. The hazard ratio of death (EVH to OVH) was 0.823 (95% CI: 0.767, 0.884). Length of hospital stay was similar between the groups (p=0.86). Post-operative pulmonary complications were more common in EVH vs OVH (14.7% vs. 12.8%, p<0.001), but repeat coronary re-vascularisation was similar between the groups. Conclusion: This large retrospective multicentre analysis indicates that EVH has a lower risk of mortality compared with OVH during the follow-up period of the study. The observed benefits of EVH may outweigh the risks but should be considered on a case-by-case basis. We hope this review gives confidence to other cardiac centres that offering an EVH approach to conduit harvesting does not affect long term patient outcomes.

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“…Hypercarbia is also influenced by the tunnel pressure or the type of system being used for EVH. [ 4 5 ] Higher tunnel pressures and closed EVH systems (which were used in this case) are associated with a higher incidence of hypercarbia.…”

mentioning

confidence: 99%

Endoscopic Saphenous Vein Harvest

Menon

Nair

Kurian

et al. 2022

Annals of Cardiac Anaesthesia

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Absorption of carbon dioxide during endoscopic vein harvest

Abstract: There was a constant increase in the blood gas concentration compared with the basal pre-procedure values. Sealed systems were associated with a significantly higher CO(2) concentration at the end of the procedure compared with the open ones.

Cited by 6 publications

References 15 publications

Saphenous vein harvesting techniques for coronary artery bypass grafting: a systematic review and meta-analysis

Saphenous vein harvesting techniques for coronary artery bypass grafting: a systematic review and meta-analysis

A multicentre review comparing long term outcomes of endoscopic vein harvesting versus open vein harvesting for coronary artery bypass surgery

Endoscopic Saphenous Vein Harvest

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