Endoscopic Vein-Graft Harvest Is Safe for CABG Surgery

Dacey, Lawrence J.

doi:10.1001/jama.2012.9079

Cited by 7 publications

(3 citation statements)

References 13 publications

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“…Several devices are available on the market for standardized procedures for saphenous vein and RA graft harvesting. With appropriate training the grafts quality is similar to open graft harvesting (60,61).…”

Section: Third Era: Development To Nowadays-minimal Invasive and Hybridmentioning

confidence: 92%

Fifty years of coronary artery bypass grafting

et al. 2018

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Coronary artery bypass grafting (CABG) remains the most common cardiac surgery performed today worldwide. The history of this procedure can be traced back for more than 100 years, and its development has been touched by several pioneers in the field of cardiac surgery, who have contributed with both their successes and failures. With ever increasing follow up and number of patients treated, thinking regarding optimal CABG technique evolves continually. This article reviews the history of CABG from its early experimental work to recent technological advances.

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Section: Third Era: Development To Nowadays-minimal Invasive and Hybridmentioning

confidence: 92%

Fifty years of coronary artery bypass grafting

et al. 2018

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“…Durante el período estudiado, nuestro equipo realizaba safenectomía con técnica de disección abierta, la cual no está exenta de morbilidad asociada a la herida operatoria, sobre todo en obesos, diabéticos o portadores de enfermedad arterial periférica. A mediados de los 90´ apareció la técnica de disección endoscópica 25 que ha mostrado reducir la morbilidad (hematoma, seroma, infección, dolor y parestesias) asociada a la safenectomía y mejorar resultados estéticos 26 . Desde el 2015 nuestro equipo incorporó la safenectomía endoscópica, utilizándola actualmente en la mayoría de los casos.…”

Section: Discussionunclassified

Cirugía coronaria: resultados inmediatos y alejados de la cirugía de revascularización miocárdica en enfermedad coronaria

et al. 2018

Rev. méd. Chile

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Early and late results of coronary artery bypass grafting in coronary artery disease in Concepcion, Chile Background: Coronary artery bypass grafting (CABG) is the best treatment for a large group of patients with coronary artery disease. Aim: To describe early and late results of patients treated with CABG at our Center. Patients and Methods: Revision of data bases, surgical protocols and clinical registers of patients operated between January 2006 and December 2008. Results: Of 1.003 cardiac surgeries performed during the period, 658 corresponded to isolated CABG (78% in men). The median age of patients was 62 years. Left common coronary artery lesions was found in 135 cases (20%), 555 patients (84%) had hypertension and 231 (35%) were diabetics. Four-hundred thirty (65%) had stable angina and 211 (32%) had a recent myocardial infarction. Twenty-two had left ventricular ejection fraction < 30%. In 248 (38%), a low Additive EuroSCORE risk was found. Emergency surgery was required in 36 (6%) patients. Use of extracorporeal circulation was required in 466 patients (71%). Within 30 days of surgery, complications were recorded in 105 patients (16%) (15 (2%) stroke, 14 (2%) myocardial infarction, 7 (1%) mediastinitis, and in 14 (2%) a reoperation for bleeding). Thirteen patients died (2%). Among the 303 patients with stable angina and preserved left ventricular function, two died (0,7%). Survival at 1, 3 and 5 years was 97,4%, 93,8% y 90,9% respectively. Major adverse cardiac and cerebrovascular events at five years occurred in 20%, stroke in 4%, myocardial infarction in 3% and reintervention in 2%. Seven percent of patients had recurrence of angina. Conclusions: We describe a heterogeneous series of patients. The immediate and late results are comparable with international communications.

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“…Neither the harvest technique nor site significantly influenced meshed SVG occlusion. Although Lopez et al questioned safety of endoscopic vein harvesting recent studies prove its uncompromised safety in the hands of experienced surgeons [ 15 , 16 ]. Our high portion of sequential meshed anastomoses confidently ruled out a negative impact on meshed SVG patency.…”

Section: Discussionmentioning

confidence: 99%

One-year patency control and risk analysis of eSVS®-mesh-supported coronary saphenous vein grafts

Inderbitzin

Bremerich

Matt

et al. 2015

J Cardiothorac Surg

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BackgroundThe eSVS® external venous nitinol mesh (Kips Bay Medical, Minneapolis, USA) was designed to improve long-term patency of coronary saphenous vein grafts (SVG) by preventing pressure-induced wall stress and reactive neo-intimal hyperplasia. We present one-year-patency rates of meshed SVGs assessed by coronary computed tomographic angiography (cCTA).Patients and MethodsData from consecutive patients receiving an eSVS® meshed coronary bypass SVG from 06/2010 to 06/2011 were prospectively collected and analysed post-hoc. Patient characteristics, coronary artery disease, SVG quality, surgery (including number of anastomoses and transit time flow-measurement: TTFM), postoperative course and graft patency by cCTA were recorded. Potential risk factors for meshed graft occlusion were evaluated.Results22 patients received an eSVS® mesh (18 isolated CABG, 4 combined with aortic valve replacement). Three patients died prior to the one-year follow-up and were excluded. All 19 surviving patients (mean age 70.4 ± 9.5 years, 3 female) completed a cCTA of all grafts at 12 ± 0.1 months after surgery including 21 meshed SVGs (33 distal anastomoses), 7 unmeshed SVGs (13 distal anastomoses) and 22 arterial grafts (30 distal anastomoses).Mesh application was safe with patent grafts (by intraoperative TTFM) and perioperative course uneventful in all patients. The average graft/anastomosis number per patient was 2.6 ± 0.5/3.7 ± 0.8. Patency was unrestricted in all arterial and unmeshed SVGs (cCTA). Meshed SVG patency was 85 % (n = 28/33) for distal anastomoses and 76 % (n = 16/21) among meshed SVGs. Four SVGs with single distal anastomosis to the right coronary were completely occluded. One sequential graft to the left coronary was occluded between proximal and first distal anastomosis (see Fig. 1). Patency was independent of target site, coronary run-off, SVG quality and sequential distal grafting. All patients were asymptomatic.ConclusionsThe overall one-year patency rate of eSVS® meshed SVGs/anastomoses was 76 %/85 %. Surgical implantation is safe independently of target site, run-off, vein quality and sequential distal anastomoses. However, graft patency of meshed veins (76 %) was inferior to non-meshed (100 %) or arterial grafts (100 %). Thus our mid-term data do not sustain the concept of improving vein graft patency by external reinforcing with the eSVS® mesh. Further long-term follow-up is warranted.

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Endoscopic Vein-Graft Harvest Is Safe for CABG Surgery

Cited by 7 publications

References 13 publications

Fifty years of coronary artery bypass grafting

Fifty years of coronary artery bypass grafting

Cirugía coronaria: resultados inmediatos y alejados de la cirugía de revascularización miocárdica en enfermedad coronaria

One-year patency control and risk analysis of eSVS®-mesh-supported coronary saphenous vein grafts

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