An Improved Technique for Long Saphenous Vein Harvesting for Coronary Revascularization

Meldrum-Hanna, W.; Ross, Donald N.; Johnson, David C.; Deal, Cedric W.

doi:10.1016/s0003-4975(10)61844-9

Cited by 22 publications

(6 citation statements)

References 7 publications

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“…The first prospective study to assess the functional quality of a saphenous vein harvested with the use of a vascular Mayo stripper was undertaken between 1979 and 1984. 6 Both light electron microscopy and scanning electron microscopy demonstrated that the harvested vein was of good quality and that the intima had been well preserved. Postoperative graft angiography and exercise testing confirmed high patency rates for the vein graft (93%).…”

Section: Discussionmentioning

confidence: 97%

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Immunocytochemical Study on Endothelial Integrity of Saphenous Vein Grafts Harvested by Minimally Invasive Surgery with the Use of Vascular Mayo Stripers. A Randomized Controlled Trial

NOWICKI¹,

BUCZKOWSKI²,

MISKOWIAK³

et al. 2004

European Journal of Vascular and Endovascular Surgery

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Objectives. The aim of this study is to compare the endothelial integrity of saphenous vein grafts harvested by minimally invasive surgery and veins harvested conventionally for coronary artery bypass surgery in 200 participants who were assigned to interventions by using random allocation. Design. Randomized controlled trial. Methods. Immunocytochemistry with anti-CD 31 antibodies and anti-nitric oxide synthase (NOS) antibodies were employed to identify the endothelial integrity. Results. The CD 31 immunostaining showed that the endothelial cell integrity of the minimally invasive harvested veins was preserved in 82^13% of the circumference of luminal endothelium, while in conventionally harvested grafts it was reduced to 64^15% (p ¼ 0.05).> This was associated with the lack of CD 31 expression in vasa vasorum (10 and 18%) in both groups, respectively, (p ¼ 0.02). The NOS immunostaining revealed that the endothelial integrity of the minimally invasive harvested grafts was preserved in 96^4% of the luminal endothelium circumference as compared to 74^10% in conventionally harvested grafts (p ¼ 0.05). The percentage of cases with the lack of NOS expression in all vasa vasorum was 12 and 21%, in G1 and G2, respectively, (p ¼ 0.02). Conclusion.The endothelial integrity of saphenous vein grafts harvested by minimally invasive surgery is better preserved than with the grafts obtained by the conventional manner. This could play an important role in improving vein graft patency rates.

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Section: Discussionmentioning

confidence: 97%

“…6 -9 One of them includes saphenous vein harvesting with the use of vascular Mayo strippers. 6 The rationale for this technique is that it provides a cushion of surrounding tissue and reduces venospasm, so that it eliminates the need of distention.…”

Section: Introductionmentioning

confidence: 99%

Immunocytochemical Study on Endothelial Integrity of Saphenous Vein Grafts Harvested by Minimally Invasive Surgery with the Use of Vascular Mayo Stripers. A Randomized Controlled Trial

NOWICKI¹,

BUCZKOWSKI²,

MISKOWIAK³

et al. 2004

European Journal of Vascular and Endovascular Surgery

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“…3 Besides producing cosmetically more acceptable scars, there is a lower incidence of wound infection. 4 Tran and colleagues 5 showed that the tunneling method resulted in better preservation of endothelial architecture than the open harvest technique, suggesting that factors other than direct handling during vein harvest are also important. Due to the lack of availability of endoscopic instruments in most centers in developing countries, locally available conventional instruments have been tried.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Saphenous Vein Harvesting Using Conventional Instruments

Agarwal

Gupta

et al. 2001

Asian Cardiovasc Thorac Ann

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“…Bridge dissection techniques (9), use of multiple small incisions or minimally invasive vein harvest using an endoscope via a single access incision can decrease the rate of wound infection, diminish wound care re- quirements, permit earlier ambulation and, from a cosmetic standpoint, result in smaller scars (7,8,10,11). Unfortunately, long term vessel patency rates for veins procured by this last method have not been definitively established (8,9).…”

Section: Discussionmentioning

confidence: 99%

Vein Donor Site Morbidity after Coronary Bypass Surgery: An Overlooked but Important Issue

Hallock

1999

Canadian Journal of Plastic Surgery

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Leg morbidity after harvest of veins for coronary artery bypass grafts (CABG) is a significant and under-recognized problem. Although it is not usually life-threatening compared with mediastinal wound infections, the absolute number of limb complications reported annually in North America is approximately double the rate of sternal wound infections. A review of the data in the Cardiac Registry at The Lehigh Valley Hospital (Allentown, Pennsylvania) for 4880 CABG patients from the past five years showed that sternal infections occurred in 48 patients (1%) compared with a reported lower limb morbidity in 31 (0.6%) hospitalized patients. This substantiates the point that morbidity is an important problem, especially if limb-threatening. Whereas many surgical protocols have been established for the treatment of mediastinal infections, there has been virtually no discussion on the management of the problematic donor limb. Plastic surgery consultation in this hospital was requested for only five (16%) patients with leg wounds, whereas it was the norm for the majority of sternal wounds (42 [87.5%]). Minimal debridement and expectant healing was the most common approach for these lower extremity wounds. An acceptable vascular profile in these patients, who often have coexistent atherosclerotic peripheral vascular disease, should be an initial priority. In those with limb complications, this had often been overlooked preoperatively. Because the failure of a wound to heal can result in limb amputation, early intervention by plastic surgeons must be emphasized.

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An Improved Technique for Long Saphenous Vein Harvesting for Coronary Revascularization

Cited by 22 publications

References 7 publications

Immunocytochemical Study on Endothelial Integrity of Saphenous Vein Grafts Harvested by Minimally Invasive Surgery with the Use of Vascular Mayo Stripers. A Randomized Controlled Trial

Immunocytochemical Study on Endothelial Integrity of Saphenous Vein Grafts Harvested by Minimally Invasive Surgery with the Use of Vascular Mayo Stripers. A Randomized Controlled Trial

Minimally Invasive Saphenous Vein Harvesting Using Conventional Instruments

Vein Donor Site Morbidity after Coronary Bypass Surgery: An Overlooked but Important Issue

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