TITLE:
A Comparative Analysis on Surgical Outcomes and Complications of Endoscopic and Open Vein Harvesting Techniques
AUTHORS:
Mohammed Fawzy Eltaweel, Ismail N. El-Sokkary, Ahmed Alherazi, Mohamed Wael Badawi, Mohammed G. Abdellatif, Bahaa A. Elkhonezy, Ibrahim K. Gamil, Haytham Mohamed Abd El Moaty, Sarra Sadmi, Mahmoud Khalil
KEYWORDS:
Endoscopic Vein Harvesting (EVH), Open Vein Harvesting (OVH), Coronary Artery Bypass Grafting (CABG), Great Saphenous Vein (GSV), Surgical Outcomes
JOURNAL NAME:
Open Journal of Thoracic Surgery,
Vol.14 No.2,
June
25,
2024
ABSTRACT: Objective: The great saphenous vein (GSV) is commonly used as a conduit for grafting during CABG surgery, and open GSV harvesting (OVH), commonly used with long incision to expose the vein. However, endoscopic vein harvesting (EVH) is an alternative approach, utilizing specialized instruments and small incisions to harvest the vein. Methods: A retrospective analysis was conducted on a cohort of patients who underwent Coronary artery bypass graft (CABG) requiring great saphenous vein (GSV) harvesting which was done by EVH or OVH procedures. Demographic variables, including age and gender, were assessed for both groups. Intraoperative variables such as the number of grafts, cardiopulmonary bypass time, X clamp time, and type of procedure were analyzed. Postoperative variables, including infection and bleeding rates, were also evaluated. Results: The study included 30 patients each undergoing Coronary artery bypass graft (CABG) with need of great saphenous vein harvesting which was done by EVH and OVH. Demographic variables were well-matched between the two groups in terms of age, while a significant difference in gender distribution was observed. Obesity and smoking were more prevalent in the OVH group, and EVH was associated with a higher mean number of grafts compared to OVH. Conversion to an open technique occurred in a portion of the EVH cases, and infection rates did not significantly differ between the EVH and OVH groups. However, the incidence of postoperative bleeding was significantly higher in the EVH group. Conclusion: This study provides valuable insights into the demographic, intraoperative, and postoperative variables associated with EVH and OVH techniques. EVH demonstrated advantages in terms of reduced infection rates compared to OVH. However, the higher incidence of postoperative bleeding associated with EVH raises concerns about potential risks.