Nova técnica cirúrgica de preparo da veia safena para revascularização do miocárdio sem manipulação direta - no-touch

Abstract

SummaryBackground: Optimization of the saphenous vein for myocardial revascularization.

Novel no touch technique of saphenous vein harvesting: Is great graft patency rate provided?

“…A classic incision is made longitudinally on the skin of the leg. The incision can be either continuous[ 2 18 20 ] or on the calf and on the thigh separately in order to avoid the multibranched SV segment of the poor quality of the knee. [ 21 ] A plane is created around the vein using scissors.…”

“…[ 21 ] The SV is extracted from its bed with its perivascular fat pedicle and all its side branches are ligated. [ 2 18 20 21 ] No venous spasm occurs as it is the perivascular tissue and not the vessel itself that it is handled by surgical instruments. [ 21 ] As a result, neither flushing nor manual dilation is required.…”

“…[ 2 18 ] Sponges soaked in pure saline solution are then used to cover the vessel and when it is totally extracted, blood from the aortic cannula serves as the storage solution. [ 2 18 20 21 ] Finally, interrupted or continuous sutures are used to close the leg wounds[ 21 ] [ Figure 1 ].…”

“…[ 1 ] This proliferation does not significantly differ between the uninjured vein and the ITA,[ 24 ] but the damaged vein endothelium results in more intense proliferation. [ 20 ] Vein wall ischemia due to loss of vasa vasorum blood supply is another contributing factor leading to intimal hyperplasia. [ 25 ]…”

The Case for Endothelial Preservation via Pressure-Regulated Distension in the Preparation of Autologous Saphenous Vein Conduits in Cardiac and Peripheral Bypass Operations

“…In “no-touch” harvesting, the graft is removed with a pedicle of surrounding tissue. This has been shown to maintain structural and functional integrity of all cell layers, prevent spasm ( 5 ), and improve graft patency ( 6 , 7 ), while conferring protection from subsequent intraoperative manipulations ( 8 , 9 ).…”