Endoscopic harvest of saphenous vein: a lesson learned from 1,348 cases

Chiu, Kuan-Ming; Chen, C.-L.; Chu, Shu‐Hsun; Lin, Taiyu

doi:10.1007/s00464-007-9522-3

Cited by 12 publications

(8 citation statements)

References 14 publications

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“…The literature search identified 236 studies, of which 25 met the inclusion criteria for review. Seven studies were excluded because EVH was used in combination with 24,25 or for coronary artery bypass surgery (CABG) and LEAB; 26 were commentary or review articles; 27e30 or were published as full-text, non-English articles. 31 One presentation abstract 32 was also excluded as the results were further published as a research paper.…”

Section: Resultsmentioning

confidence: 99%

Endoscopic Vein Harvesting in Lower Extremity Arterial Bypass: A Systematic Review

Jauhari¹,

Hughes²,

Black

et al. 2014

European Journal of Vascular and Endovascular Surgery

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Section: Resultsmentioning

confidence: 99%

Endoscopic Vein Harvesting in Lower Extremity Arterial Bypass: A Systematic Review

Jauhari¹,

Hughes²,

Black

et al. 2014

European Journal of Vascular and Endovascular Surgery

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“…Analysis of 1348 patients undergoing EVH revealed that the average procedural time of the first 50 cases was 68 minutes, while the procedural time dropped significantly to 23 minutes in the last 200 cases [6]. In general one can expect a personal learning curve of 20–100 procedures, depending on surgical experience.…”

Section: Procedure Learning Curve and Safetymentioning

confidence: 99%

“…The few case reports describing EVH specific complications relate to the use of CO 2 insufflation, namely, severe hypercapnia, subclinical CO 2 embolization (10.4%), and massive CO 2 embolization (0.22%) [6, 7]. An important preventive measure is reduction of the CO 2 insufflation pressure, most importantly not allowing the CO 2 pressure to surpass the central venous pressure.…”

Section: Procedure Learning Curve and Safetymentioning

confidence: 99%

Endoscopic Vein Harvesting for Coronary Bypass Grafting: A Blessing or a Trojan Horse?

Accord

2011

Cardiology Research and Practice

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Conventional open harvest of the great saphenous vein (GSV) during CABG results in approximately 7% donor-site complications. Using endoscopic vein harvesting (EVH) the full GSV length can be harvested through a 3 cm incision. This nonsystematic review discusses several key issues concerning EVH, based on an extensive Pubmed search. Found studies show that EVH results in reduced number of wound complications, less postoperative pain, earlier postoperative mobilisation, reduced length of hospital stay, and is more cost-effective. Initial studies did not find significant differences in graft histology, patency, or clinical outcome. However, in 2009 convincing evidence of inferior histological graft properties became available. Furthermore, an observational study showed that EVH resulted in significantly more graft stenosis, was associated with higher mortality, more myocard infarction, and more reinterventions. Most recent publications could not confirm these findings, however larger randomised controlled trials focusing on graft quality are being awaited.

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“…Irrespective of the device used, a short skin incision of 2-3cm is enough to harvest the vein (two-to three-vein conduit segments and the radial artery). Several groups have reported a fast learning curve with the endoscopic technique, with procedure duration reducing to an acceptable 20-30 minutes after the first few cases 51.…”

mentioning

confidence: 99%

Outcome of Coronary Artery Bypass Grafting – Strategies for Improvement

Rastan¹,

Falk²

2011

European Cardiology Review

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During recent years, new conceptual, technical and drug strategies have led to improved early and late outcomes after coronary artery bypass surgery. These new strategies can be divided into the following three groups: optimisation of pre-operative patient selection and indications for and timing of the operation; peri-procedural refinements, including new techniques and instruments to avoid extracorporeal circulation, reduce aortic manipulation and minimise surgical access; and improvements to post-operative care, such as fast-track protocols and long-term drug therapy. In summary, the wide range of the surgical armamentarium available today allows cardiovascular surgeons to adapt the surgical strategy to individual patients and the given clinical scenario. This article aims to describe clinical rationales for the adoption of new concepts, provide an introduction to technical details and discuss clinical study results where appropriate.

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Endoscopic harvest of saphenous vein: a lesson learned from 1,348 cases

Abstract: The findings showed EVH of saphenous vein to be a valid alternative to open saphenectomy, providing excellent surgical results. Therefore, EVH should be considered as the standard of care for saphenous vein harvest.

Cited by 12 publications

References 14 publications

Endoscopic Vein Harvesting in Lower Extremity Arterial Bypass: A Systematic Review

Endoscopic Vein Harvesting in Lower Extremity Arterial Bypass: A Systematic Review

Endoscopic Vein Harvesting for Coronary Bypass Grafting: A Blessing or a Trojan Horse?

Outcome of Coronary Artery Bypass Grafting – Strategies for Improvement

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