Intercorrências clínicas no membro submetido à exérese de veia safena magna para revascularização do miocárdio

Abstract

Intercorrências clínicas no membro submetido à exérese de veia safena magna para revascularização do miocárdioClinical complications of limb undergone harvesting of great saphenous vein for coronary artery bypass grafting using bridge technique Abstract Objective: The aim of this study was to assess clinical complications of limbs undergone harvesting of the great saphenous vein for venous coronary artery bypass graft surgery using bridge technique.Methods: Fourty-four patients who had undergone CABG using the great saphenous vein harvested by the bridge technique over more than 3 months ago were randomly selected. The exclusion criteria were the harvesting of both saphenous veins, prior saphenectomy of the contralateral limb, edema caused by a systemic etiology, such as heart, renal, thyroid or hepatic diseases and venous insufficiency of the lower limbs as characterized by swollen varicose veins both with and without trophic changes. The age, gender, diabetes, time of surgery and occurrence of complications, such as edema, paresthesia, infection, lymphorrhea, erysipelas and deep venous thrombosis, were assessed. The assessment was clinic and diagnosis of the diabetes was performed by the preoperative exams. The chisquare, Fisher and Student's t tests were used for statistical analysis with an alpha error of 5%.Results: The time between surgery and assessment ranged between 3 and 187 months with a mean of 47.3±42.5 months. Infections of the saphenous harvest site were detected in 25% of the cases, edema in 52.3%, paresthesia in 29.5%, erysipelas in 9.1%, lymphorrhea in 4.5% and deep venous thrombosis in 2.3%. There was no association between diabetes and complications.Conclusion: The saphenous vein harvesting using bridge technique for coronary artery bypass grafting does not eliminate clinical complications, such as paresthesia, infection and edema of the saphenous vein harvesting site. Descriptors:Saphenous vein. Myocardial revascularization. Postoperative complications/etiology. Coronary artery bypass/methods. ResumoObjetivo: Avaliar as intercorrências clínicas nos membros submetidos a retirada da veia safena magna por técnica de incisões escalonadas para sua utilização como enxerto venoso na revascularização do miocárdio.Métodos: Selecionou-se aleatoriamente 44 pacientes submetidos a revascularização do miocárdio utilizando a veia safena magna retirada por incisões escalonadas há mais de 3 meses. Critérios de exclusão: retirada da veia safena de ambos os lados; safenectomia prévia do membro contralateral; etiologias de edema de causas sistêmicas, tais como cardíacas, This study was carried out at the Clinics of Cardiac Surgery of Maringá, PR.

Prevention of edema after coronary artery bypass graft surgery by compression stockings

“…However, Khoshgoftar et al concluded in their study that changing leg posture, being out of bed and walking 24 hours after the operation and lower limb physiotherapy had no significant effect on donor limb edema ( 16 ). Diuretic use and the history of diabetes mellitus had no effect on the incidence of lower limb edema 4 weeks after the operation, similar to the studies of Khoshgoftar et al ( 16 ) and Belczak et al ( 18 ). Our study also revealed that there was no relation between the low sodium diet and the incidence of edema 4 weeks post-op.…”

“…The incidence of wound complications at the site of saphenous vein harvesting had no effect on the incidence of the lower limb edema in our study. In the study of Belczak et al the incidence of suture infection at lower limb after CABG surgery was reported 25%; however, its relation with the incidence of edema was not evaluated ( 18 ). There was no relation between the method of saphenous vein harvesting and the incidence of edema four weeks after the surgery.…”

“…There was no relation between the method of saphenous vein harvesting and the incidence of edema four weeks after the surgery. In the similar study, the effect of the number and the length of the surgical incisions on the incidence of lower limb edema were evaluated and concluded that these factors had no effect on the incidence of postoperative edema ( 18 ).…”

Incidence of Venous Thromboembolism and Benefits and Risks of Thromboprophylaxis After Cardiac Surgery: A Systematic Review and Meta‐Analysis

“…The majority of the studies were observational studies (n=49), 16 studies were RCTs, and 3 were meta‐analyses (Tables 1 and 2). 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84 Of the 16 RCTs identified,1...…”

Alterações linfocintilográficas após retirada da veia safena para ponte da artéria coronária

“…Study published in this journal reported on complications after saphenous vein harvesting such as paresthesia, lymphorrhea, infection and deep venous thrombosis [1]. Another study in this journal showed that leg wound complications were observed more in the traditional long incision vein harvesting technique (P=0.0005).…”