What is the impact of endoscopic vein harvesting on clinical outcomes following coronary artery bypass graft surgery?

Grant, Stuart W; Grayson, Antony D.; Zacharias, Joseph; Dalrymple-Hay, M.; Waterworth, Paul; Bridgewater, Ben

doi:10.1136/heartjnl-2011-300600

Cited by 34 publications

(19 citation statements)

References 30 publications

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“…In the US study of 235 394 Medicare CABG patients in the Society of Thoracic Surgeons (STS), national database mortality rates were similar regardless of harvesting technique, while rates of harvest site complications were lower for the endoscopic technique (58). A UK study of 4702 CABG patients reported similar findings with no differences in in-hospital mortality (0.9% vs. 1.1%, p=0.71) or midterm mortality (HR 1.04; 95% CI 0.65 to 1.66) for endoscopic versus open vein harvesting (59).…”

Section: Secondary Prevention Of Stable Coronary Diseasesupporting

confidence: 58%

Almanac 2013-stable coronary artery disease

Islam

2014

Anadolu Kardiyol Derg

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ALMANAC series 219Coronary heart disease in decline Epidemiological data from Europe, the USA and elsewhere in the developed world show a steep decline in coronary heart disease (CHD) mortality during the last 40 years (1). Concern about levelling of mortality rates in younger adults (2) has been somewhat alleviated by data from The Netherlands showing that in men aged <55 years, rates of decline have again accelerated, increasing from only 16% in 1993-1999 to 46% in 1999-2007 (3). A similar pattern was observed in young women with rates of decline of 5% and 38% during the same time periods. This is encouraging, particularly in the context of data from Denmark and the UK showing declining mortality and also a sharp fall in standardised incidence rates for acute myocardial infarction indicating that coronary prevention, as well as acute treatments, has contributed to recent mortality trends (4, 5). Meanwhile an Australian study reminds us that myocardial infarction is but one of several manifestations of cardiovascular disease by reporting that decreasing incidence and recurrence rates for hospitalised CHD from 2000 to 2007 have also been seen for cerebrovascular and peripheral arterial disease (6).However, the epidemiological news is not all good, and data from the UK show that the pernicious relationship between socioeconomic status (SES) and CHD has shown no tendency to go away in recent years, the gradients between top and bottom SES quintile groups for hospital admissions remaining essentially unchanged across the age range (7). Whether this has contributed to the almost 3-fold risk of myocardial infarction associated with stillbirth and 9-fold risk associated with recurrent miscarriage in a recent German study is unclear because the investigators made no adjustment for SES (8). Nor is it clear if SES has contributed to the persistent ethnic differences in both US and UK studies of CHD mortality although other factors appear also to be important. Thus, African-American men have greater exposure to CHD risk factors than Caucasians and, when adjustment is made for this, their susceptibility to CHD is no greater, although mortality rates are twice as high (9). For African-American women, incidence and mortality rates are higher than their Caucasian counter-parts. These findings suggesting that exposure to risk factors contributes to ethnic differences in the incidence of CHD are to some extent reflected in a recent report from the Health Survey for England in which 13 293 Caucasian and 2120 S Asians consented to mortality followup (10). Physical inactivity increased susceptibility to disease and not by increased case-fatality rates (11). Diagnosis of stable coronary artery diseaseThe recent AHA/ACC guideline update (12) emphasised the importance of individualising the diagnostic workup based on the estimated probability of coronary artery disease. In this respect, it mirrored an earlier National Institute of Clinical Excellence (NICE) guideline on chest pain diagnosis (13), but there were important differences ...

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Section: Secondary Prevention Of Stable Coronary Diseasesupporting

confidence: 58%

Almanac 2013-stable coronary artery disease

Islam

2014

Anadolu Kardiyol Derg

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“…58 A UK study of 4702 CABG patients reported similar findings with no differences in in-hospital mortality (0.9% vs 1.1%, p=0.71) or midterm mortality (HR 1.04; 95% CI 0.65 to 1.66) for endoscopic versus open vein harvesting. 59 Also under scrutiny have been the relative benefits of off-pump and on-pump CABG. Each has its proponents, 60 61 but the results of randomised outcome trials have failed to show any clear advantage for off-pump CABG, the 3-year results of the Best Bypass Surgery Trial showing no significant difference in the primary composite outcome of MACCE compared with on-pump CABG, but a tendency towards higher mortality.…”

Section: Revascularisation In Stable Cadmentioning

confidence: 99%

Almanac 2013: Stable coronary artery disease the national society journals present selected research that has driven recent advances in clinical cardiology

Timmis

2014

Srce i krvni sudovi

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“…The Authors' reply We would like to thank Wong et al for their comments regarding our manuscript1 and for the presentation of results from their study comparing in-hospital outcomes between patients receiving endoscopic vein harvesting (EVH) and open vein harvesting (OVH) for coronary artery bypass graft surgery (CABG) 2. Demonstrating comparable in-hospital, mid-term and long-term clinical outcomes following EVH is important as there is little doubt about the success of EVH in reducing donor site morbidity compared with OVH.…”

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confidence: 94%

“…No specific criteria were used for selecting the patients who underwent EVH in our study and patient variables which could potentially influence the choice of harvesting method such as age, body mass index or diabetic status were comparable between patients who received EVH and OVH prior to propensity matching 1. However, a lower proportion of EVH patients were women and a higher proportion of OVH patients had peripheral vascular disease which may represent potentially unmeasured patient selection in our practice.…”

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confidence: 99%