Is minimally invasive harvesting of the great saphenous vein for coronary artery bypass surgery a cost-effective technique?

Abstract

Minimally invasive harvesting is the most cost-effective method of harvesting the great saphenous vein and can significantly improve a patient's quality of life.

Endoscopic radial artery harvesting for coronary artery bypass grafting. A single center evolving experience

“…In contrast to EVH when significant decrease of wound-healing complications, in-hospital stay, and need for further out patient care support its cost-effectiveness, it remains questionable whether reduction of neurological impairment and better cosmetic results outweigh the cost of ERAH, particularly if single use devices are employed 29 . We are aware that there was only a total of 91 RAs harvested (54.9% endoscopically) during the tracking period.…”

Long-term Cost-effectiveness of Endoscopic vs Open Vein Harvest for Coronary Artery Bypass Grafting

“…Two studies have investigated the short-term cost-effectiveness of EVH or minimal invasive vein harvesting compared to OVH [4,5]. Rao et al performed decision analytic modeling and estimated that minimal invasive vein harvesting was cost-effective compared to conventional harvesting within six weeks postoperatively [5].…”

“…Rao et al performed decision analytic modeling and estimated that minimal invasive vein harvesting was cost-effective compared to conventional harvesting within six weeks postoperatively [5]. In a costeffectiveness analysis alongside a randomized trial, Oddershede et al concluded that EVH was not cost-effective compared to OVH within the first five weeks postoperatively [4].…”

“…Meta-analysis of the clinical evidence show that EVH is a short-term benefit as leg wound morbidity, infections, and pain is reduced without compromising the long-term safety as no differences were observed in the recurrence of chest pain, myocardial infarctions, and all-cause mortality [1][2][3]. Previous economic evaluations of EVH versus OVH have looked at costs and outcomes five to six weeks postoperatively [4,5]. Such a short time-horizon is suitable for an economic evaluation if costs and outcomes can be considered equal between treatment groups after the period in which they are compared [6].…”

Invited Commentary

“…Although the effect of MIVH on patient morbidity from wound-related complications has been extensively investigated in the literature, the effect on the quality of the harvested conduit is less clear [1,2]. However, before attempting this comparison, it is important to consider the characteristics that would be expected of a high-quality conduit, namely its macroscopic appearance, histologic quality (with particular regard to endothelial continuity), functional characteristics, and mid-term and long-term patency [3].…”