Impact of endoscopic versus open saphenous vein harvest technique on late coronary artery bypass grafting patient outcomes in the ROOBY (Randomized On/Off Bypass) Trial

Zenati, Marco A.; Shroyer, A. Laurie; Collins, Joseph F.; Hattler, Brack G.; Ota, Takeyoshi; Almassi, G. Hossein; Amidi, Morteza; Novitzky, D.; Grover, Frederick L.; Sonel, Ali F.

doi:10.1016/j.jtcvs.2010.10.004

Cited by 139 publications

(88 citation statements)

References 25 publications

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“…Despite the above advantages, there are concerns regarding the detrimental effect on vein endothelium because of stretching and pulling, and promoting thrombosis, thus leading to early graft closure. 57,58 Nevertheless, endo vein harvest is associated with less readmission, antibiotic use, wound care, and need for surgical intervention, and should be promoted over the open vein harvesting technique.…”

mentioning

confidence: 99%

Saphenous vein harvest wound complications: risk factors, identification, prevention, and management

Siddiqi¹

2016

CWCMR

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Coronary artery bypass grafting is a commonly performed surgery worldwide that gives good results. Great saphenous vein is used as a conduit for bypass in over 95% cases. The harvesting technique has remained unchanged over the years. However, wound complications from harvesting the great saphenous vein by open method can be a major source of postoperative morbidity. With the objective of preventing major complications, identification of risk factors for saphenous vein harvest site infection is important. It is imperative to develop approaches that prevent infection and to allow for early recognition of patients who are at high risk and who may need more watchful monitoring so as to prevent development of wound complications. It is desirable to assess the patient completely, delineate the anatomy of peripheral vessels particularly in a patient with associated peripheral vascular disease, identify the best site to perform the saphenous vein harvest incision, employ a meticulous surgical technique, recognize complications early, and start the recommended treatment without delay. The aim of this paper is to identify the risk factors for saphenous vein harvest site complications and their identification, prevention, and management.

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confidence: 99%

Saphenous vein harvest wound complications: risk factors, identification, prevention, and management

Siddiqi¹

2016

CWCMR

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“…As described previously, a subgroup analysis of the ROOBY trial suggested that endoscopic vein harvesting was associated with worse outcomes (21). A secondary analysis of patients from the PREVENT IV trial at 3 years of follow-up also showed worse outcomes for patients undergoing endoscopic harvesting, but this finding has not been confirmed in other observational studies (29,31).…”

Section: Is Endoscopic Vein Harvesting Safe?mentioning

confidence: 82%

Almanac 2012 adult cardiac surgery

Bridgewater¹

2013

Anadolu Kardiyol Derg

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This review covers the important publications in adult cardiac surgery in the last few years, including the current evidence base for surgical revascularisation and the use of off-pump surgery, bilateral internal mammary arteries and endoscopic vein harvesting. The changes in conventional aortic valve surgery are described alongside the outcomes of clinical trials and registries for transcatheter aortic valve implantation, and the introduction of less invasive and novel approaches of conventional aortic valve replacement surgery. Surgery for mitral valve disease is also considered, with particular reference to surgery for asymptomatic degenerative mitral regurgitation. (Anadolu Kardiyol Derg 2013; 13: 414-21) ALMANAC series ALMANAC serileri 414

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“…One major limitation of the current literature is that there is very little conclusive data regarding long-term patency rates of endoscopically harvested veins. There are some concerns that endoscopic vein harvest could be connected with a detrimental effect on vein endothelium which could promote a thrombogenic environment leading to a decrease in graft patency (Rousou et al 15 and Zenati et al 16 ). In our study, we found a statistically significant difference between the EVH and OVH groups in terms of percentage of endothelial damage which was statistically significantly higher in the EVH group.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic vs open saphenous vein harvest for coronary artery bypass grafting: A leg-related morbidity and histological comparison

Brát¹,

Horáček²,

Sieja³

2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims. The aim of this study was to compare coronary artery bypass grafting (CABG) using either endoscopic (EVH) or open harvest (OVH). Leg-related morbidity and histological comparison of the veins were the outcome measures. Methods. One hundred consecutive patients scheduled for isolated CABG were randomly divided into two goups: an EVH and OVH group. Perioperative data were recorded. Patients were examined 7 days and 1 month postoperatively for leg-related morbidity. Samples for histological examination were taken from each harvested vein during the surgery. Results. Postoperative pain was statistically significantly lower in the EVH group 7 days postoperatively but the incidence of haematoma was non statistically higher in the EVH group while swelling was higher in the OVH group. Almost 40% of all histological samples were described as showing endothelial damage. There was significantly more endothelial damage in the EVH than the OVH group. Conclusions. We confirmed the advantage of EVH in terms of leg-related morbidity as well as cosmetic effect. This method however, was associated with more acute endothelial damage of the graft. These results support concerns that endoscopic vein harvest may be connected with detrimental effects on vein endothelium which could promote a thrombogenic environment leading to a decrease in graft patency. This could be extremely important. The results suggest that further investigation of the long-term patency of vein grafts harvested endoscopically is required.

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Impact of endoscopic versus open saphenous vein harvest technique on late coronary artery bypass grafting patient outcomes in the ROOBY (Randomized On/Off Bypass) Trial

Abstract: In the ROOBY Trial, endoscopic vein harvest was associated with lower 1-year saphenous vein graft patency and higher 1-year revascularization rates, independent of the use of off-pump or on-pump cardiac surgical approach.

Cited by 139 publications

References 25 publications

Saphenous vein harvest wound complications: risk factors, identification, prevention, and management

Saphenous vein harvest wound complications: risk factors, identification, prevention, and management

Almanac 2012 adult cardiac surgery

Endoscopic vs open saphenous vein harvest for coronary artery bypass grafting: A leg-related morbidity and histological comparison

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