Techniques, Complications, and Pitfalls of Endoscopic Saphenectomy for Coronary Artery Bypass Grafting Surgery

Perrault, Louis P.; Kollpainter, R. E.; Pagé, Pierre; Miles, Ronald G.; Tanguay, Daniel; Carrier, Michel

doi:10.1111/j.1540-8191.2005.scs13.x

Cited by 10 publications

(4 citation statements)

References 15 publications

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“…The use of CO 2 reduces vein trauma and hematoma [11]. In contrast, there have been reports of CO 2 embolism, pneumothorax, subcutaneous emphysema, and hypercarbia [12]. …”

Section: Discussionmentioning

confidence: 99%

A case report of a carbon dioxide embolism caused by endoscopic vein harvesting during cardiac surgery -A case report-

Fan

Denisco

Knorz

et al. 2012

Korean J Anesthesiol

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A carbon dioxide (CO2) embolism during endoscopic vein harvesting is a rare but potentially fatal complication. Early and accurate diagnosis is crucial for limiting the extent of the embolism and stabilizing the resulting cardiovascular compromise. We report a case of CO2 embolization during endoscopic vein harvesting. Transesophageal echocardiography was instrumental in the diagnosis and management of this patient by further improving the decision making process, which resulted in the best outcome. Mid-esophageal bicaval view is the best view to determine whether a CO2 embolism is coming from the upper or lower extremities.

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“…The use of CO 2 reduces vein trauma and hematoma [11]. In contrast, there have been reports of CO 2 embolism, pneumothorax, subcutaneous emphysema, and hypercarbia [12]. …”

Section: Discussionmentioning

confidence: 99%

A case report of a carbon dioxide embolism caused by endoscopic vein harvesting during cardiac surgery -A case report-

Fan

Denisco

Knorz

et al. 2012

Korean J Anesthesiol

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“…Need for direct revision of leg hemostasis is rare in our experience of more than 1000 endoscopic vein harvestings. 4 Second, although quickly suspected, the diagnosis of carbon dioxide embolism was not made before CPB reinstitution, since at the time of the gaseous reinsufflation, the transesophageal echocardiographic (TEE) monitoring was discontinued. Since it has been shown to be the most effective method for detection of gaseous embolisms, 5 TEE should always be available during insufflation.…”

Section: Carbon Dioxide Embolism Induced By Endoscopic Saphenous Vein Harvesting During Coronary Artery Bypass Grafting To the Editormentioning

confidence: 99%

Carbon dioxide embolism induced by endoscopic saphenous vein harvesting during coronary artery bypass grafting

Mommerot

Perrault

2006

The Journal of Thoracic and Cardiovascular Surgery

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“…La eficacia de ambos dispositivos en el sellado de vasos sanguíneos y de otros tejidos se conoce ampliamente en el campo de la cirugía abdominal, torácica o cervical, según otros estudios previos (3,8,9). En el ámbito de la cirugía de la revascularización coronaria, también se han empleado estos dispositivos para la disección endoscópica de la vena safena interna o la arteria radial, con una buena permeabilidad del injerto y menor tasa de infección de heridas (10,11).…”

Section: Introductionunclassified

Animal model for assessing collateral vein sealing with energy-based devices in revascularization surgery

Espínola¹,

Andani²,

Velasco³

et al. 2023

Angiologia

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Introduction: energy sealing devices achieve hemostasis of the vessels through the heat generated and coagulation of the vascular wall's proteins. However, mid-term efficacy for venous graft sealing in arterial bypass surgery, remains unknown Objectives: to create an animal model which allows the comparison of mid-term efficacy and safety at the sealing zone after the healing process. To compare and assess which in vivo arterial models show lower morbidity and higher survival after 4 weeks postoperative. Material and methods: an in vivo experimental study of 16 New Zealand rabbits. In each rabbit a human saphenous vein (SV) with at least one venous collateral was implanted. Two arterial models were developed: infrarrenal aorta bypass with SV (n = 5) and aortoplasty with SV patch (n = 11). In both models the collateral was randomized ad sealed with one energy sealing devices: Electrothermal Bipolar Vessel Sealing (EBVS) or Harmonic scalpel (HS). Every animal was treated with antithrombotic prophylaxis and immunosuppressive medication. Intraoperative mortality, paraplegia, infection, bleeding, and survival was analyzed. Results: two animals (50 %) survive at the 7th postoperative day in the bypass model, but anyone survived the four weeks postoperative in this model. In the aortoplasty group, seven-day survival was 55,56 % (5/9) and 4-weeks survival was 44,44 % (4/9) (p = 0.05). Paraplegia rate was 100 % for the bypass model and much lower for the patch group (25 %) (p = 0,03). Mean ischemic time was lower for the aortoplasty model (37,11 ± 8,1 min) compared to bypass group (42 ± 10,61 min) (p = 0.414). No animal presented intrabdominal hemorrhage or adverse drug reaction for immunosuppressive medication. Conclusion: aortoplasty with SV patch model has shown a lower paraplegia rate and a lower mortality at 7 days in the animal model performed. Both bypass model and patch model have shown efficacy at the sealing zone but only in the aortoplasty model four animals survived after 4 weeks.

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Techniques, Complications, and Pitfalls of Endoscopic Saphenectomy for Coronary Artery Bypass Grafting Surgery

Abstract: Adherence to the comprehensive approach presented in this text should to ensure retrieval of high-quality grafts with a low complication rate providing patients with the full benefits, both cardiac and functional, of this minimally invasive technique of saphenous vein harvesting for CABG.

Cited by 10 publications

References 15 publications

A case report of a carbon dioxide embolism caused by endoscopic vein harvesting during cardiac surgery -A case report-

A case report of a carbon dioxide embolism caused by endoscopic vein harvesting during cardiac surgery -A case report-

Carbon dioxide embolism induced by endoscopic saphenous vein harvesting during coronary artery bypass grafting

Animal model for assessing collateral vein sealing with energy-based devices in revascularization surgery

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