Endoscopic harvesting will secure a silver medal for the no-touch saphenous vein and bronze for the radial artery

Dashwood, Michael R.; Silva, Heber Souza Melo; Lima, Melchior Luiz

doi:10.1016/j.jtcvs.2020.01.076

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…Screen shot from video footage taken during endoscopic SV harvesting showing exposure of the SV, separation of perivascular adipose tissue (PVAT), and vasa vasorum (arrows). (From Dashwood et al [ 62 ] , 2020). …”

Section: Discussionmentioning

confidence: 99%

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Towards Endoscopic No-Touch Saphenous Vein Graft Harvesting in Coronary Bypass Surgery

Kopjar

Dashwood

2022

Braz J Cardiovasc Surg

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The saphenous vein is the most used conduit for coronary artery bypass surgery. However, the patency rate of this graft is inferior to the internal thoracic artery patency rate, which is the gold standard. Using the conventional technique, the saphenous vein is harvested via a large open incision and excised in such a way that causes both vascular damage and wound healing complications. Consequently, vein graft patency and surgical site infection may be compromised. Graft patency is markedly improved when the saphenous vein is harvested atraumatically with minimal damage and with surrounding cushion of perivascular fat intact. However, despite the improved graft performance, wound healing complications and infection remain a problem. Although wound healing complication is reduced when using endoscopic vein harvesting, there may be a negative impact on graft performance. This is due to vascular damage associated with application of forces to the vein that are usually avoided in open vein harvesting, including traction, adventitial stripping, and venous compression. There is evidence to suggest that improved patency of endoscopically harvested saphenous veins is associated with the surgeon’s experience of the technique. Recently, endoscopic methods of harvesting have been described where the saphenous vein is removed intact and with minimal vascular damage caused. In addition, wound healing complications, infection, and scarring are reduced. While the effect of these techniques on vein graft patency have yet to be reported, the ability to obtain a superior graft with reduced wound complications will be of great benefit to patients undergoing coronary revascularization procedures.

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Section: Discussionmentioning

confidence: 99%

“…Given the marked improvement in NT SVG patency and the reduced leg wound complications when using EVH, these recent studies may pave the way towards a greater use of NT SVG, securing its position as the second conduit of choice for CABG [ 62 ] .…”

Section: Discussionmentioning

confidence: 99%

Towards Endoscopic No-Touch Saphenous Vein Graft Harvesting in Coronary Bypass Surgery

Kopjar

Dashwood

2022

Braz J Cardiovasc Surg

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“…evidenced by numerous histologic and some clinical studies, [4][5][6][7] and it is encouraging that endoscopic harvesting techniques are being explored for the NT-SVG to address leg infection rates. 1 With regard to endoscopic harvesting, comparative studies have predominantly involved endoscopic conventional saphenous vein graft (SVG) versus open conventional SVG harvesting (Veterans Affairs study by Zenati and colleagues 8 ). Clinical trials of NT-SVGs have exclusively used an open approach.…”

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confidence: 99%

Reply from the authors: The race for the second best…continues—The no-touch saphenous vein versus the radial artery

Deb

Fremes

2020

The Journal of Thoracic and Cardiovascular Surgery

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We thank Dashwood and colleagues 1 for their reply to our commentary regarding the use of the radial artery (RA) and no-touch saphenous vein graft (NT-SVG) in patients undergoing coronary artery bypass grafting surgery. 2 Our commentary was predicated on the recently published 8-year patency results of a single-center randomized controlled trial comparing the RA with the NT-SVG by Dreifaldt and colleagues. 3 We agree that NT-SVG has excellent potential as

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REPLY: Winners: Where, when, and why

Hui

Lee

2020

The Journal of Thoracic and Cardiovascular Surgery

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Endoscopic harvesting will secure a silver medal for the no-touch saphenous vein and bronze for the radial artery

Cited by 4 publications

References 7 publications

Towards Endoscopic No-Touch Saphenous Vein Graft Harvesting in Coronary Bypass Surgery

Towards Endoscopic No-Touch Saphenous Vein Graft Harvesting in Coronary Bypass Surgery

Reply from the authors: The race for the second best…continues—The no-touch saphenous vein versus the radial artery

REPLY: Winners: Where, when, and why

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