Clinicopathological comparisons of open vein harvesting and endoscopic vein harvesting in coronary artery bypass grafting patients in Mashhad

Abstract

IntroductionHarvesting of the greater saphenous vein is almost an inevitable part of coronary artery bypass grafting (CABG) operations, and it is done by two main techniques, i.e., conventional or open vein harvesting (OVH) and the minimally-invasive endoscopic vein harvesting (EVH). This study aimed to compare these two techniques in off-pump CABG procedures with respect to clinical and pathological outcomes.MethodsThis cohort study was conducted on CABG candidates during a one-year period from October 2013 through September 2014 in the Department of Cardiac Surgery at Mashhad University of Medical Sciences. Eighty-seven patients voluntarily underwent EVH, and another 86 patients matched for age, gender, and other cardiovascular risk factors were selected for OVH. They were followed up for six weeks, and the main outcome measures were infections of the wound, pain, duration of hospital stay, and the costs of hospitalization. Paired sample t-test, independent t-test, or their non-parametric equivalents and the chi-squared test were used by SPSS version 17.0 for data analysis.ResultsThe mean duration of time for vein harvesting was shorter in the EVH group (p < 0.001), and the pain score was lower (p = 0.04). No infections occurred at the site of the wound. The length of hospital stay was not significantly different for the two groups (OVH versus EVH: 8.5 ± 3.3 versus 8.4 ± 3.2 days; p-value: 0.08). Hospitalization costs were significantly higher in the EVH group (OVH versus EVH: 5.8 ± 4.7 versus 7.3 ± 2.0 million Tomman; p-value: 0.008), yet no difference was diagnosed with respect to endothelial damage in the vein grafts harvested by the EVH and OVH techniques.ConclusionEVH is considered as a minimally invasive and safe vein harvesting technique in our Center, and it can reduce the harvesting time and post-operative pain. In addition, its efficiency was similar to that of OVH.

Comparison of the Outcomes after Endoscopic Vein Harvesting Versus Open Vein Harvesting for Coronary Bypass Surgery

“…Moeinipour, et al also supported this finding. In a study showing that patients in the endoscopic-vein harvesting group have experienced less pain than patients in the open-vein harvesting group and pain scores during the 6-week follow-up were significantly reduced [8].…”

“…During the follow-up period, antibiotics were administered to 14.4% of the patients in the open-harvest group compared to only 4.6% of the patients in the endoscopic-harvest group. The prior investigation by Moeinipour, et al in 2016 studied 87 patients who underwent endoscopic-vein harvesting, have implemented that the reason of the zero-infection rate observed with the endoscopic-vein harvesting patients is due to the smaller incisions and preserved tissue perfusion with this approach [8]. A study by Nezafati, et al concluded that in order to decrease wound related complications associated with the extensive incisions, endoscopic vein harvesting is recommended to reduce wound complications, leg wound infection and hematoma.…”

“…In contrast to the previous study, several studies in the broader literature have examined endothelial integrity post-harvesting. Moeinipour, et al in 2016 reported that endothelial injury of the grafts showed no meaningful difference between the two harvesting techniques [OVH 2.3% vs. EVH: 0.0%] [8]. Similarly, a study by Nezafati, et al enrolled 47 patients, 30 patients underwent endoscopic-vein harvesting and 17 patients underwent openvein harvesting.…”

Early and Late Survival and Associated Factors in Patients Undergoing Coronary Artery Bypass Grafting

“…Moreover, the efficiency of EVH and OVH is similar. Nevertheless, further research is needed to probe into its cosmetic outcomes, cost-efficiency, and hospital costs; it is even more essential to study the long-term graft patency of the EVH technique [16].…”

Comparison of Life Quality in Patients Undergoing Open Vein Harvesting and Endoscopic Vein Harvesting Techniques: A Prospective Cohort Study

“…A frequent choice in coronary artery bypass grafting (CABG) operations is to harvest the greater saphenous vein, which is primarily performed through two procedures as minimally-invasive endoscopic vein harvesting (EVH) and open vein harvesting (OVH) (1).…”