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Current practice of saphenous vein graft harvesting in coronary artery bypass graft surgery: an Indian survey

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

An Invited editorial to this article was published on 31 December 2022

Abstract

Purpose

The treatment of occluded saphenous vein graft (SVG) is challenging, and thus preventing the graft occlusion is of utmost importance. However, despite its recognized importance, a paucity of data exists regarding how SVGs are handled and preserved. Hence, this survey was conducted to document the techniques of vein graft preservation and handling among cardiac surgeons in India.

Methods

The survey had 26 questions regarding vein graft usage, harvesting, handling, and preservation techniques. Three hundred cardiac surgeons across India participated in this survey between March 2019 and July 2019.

Results

Responses were received from 215 (71.6%) surgeons across 13 states. Around 87% of respondents reported that ≥ 76% of veins were harvested by the open technique. Among the respondents, around 67% used one SVG in ≥ 96% of their patients, 45% used two SVGs in ≥ 86% of their patients, and 38% used ≥ 3 SVGs in < 25% of their patients, respectively. Around 54%, 27%, 9%, and 9% of respondents used autologous whole blood, saline solution, pH-buffered solution, and other solutions, respectively. In addition, 96.74% of respondents heparinized their vein graft preservation solutions, and 98.14% preserved the solution at room temperature. 34.88% and 83.26% of respondents used dual antiplatelet therapy (DAPT) before and after surgery in ≥ 76% of their patients, respectively. 63.26% of the surgeons reported that the patients received DAPT for > 12 months.

Conclusion

There is a significant variance in the process of vein harvesting, preservation, handling, and antiplatelet therapy protocols among various cardiac surgeons across India. Therefore, there is a need for standardization in the practice of vein harvesting.

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Author notes

  1. Lokeswara Rao Sajja

    Present address: Division of Clinical Research in Cardiovascular Medicine/Surgery, Sajja Heart Foundation, Srinagar Colony, Hyderabad, 500073, India

Authors and Affiliations

  1. Department of Cardiothoracic Surgery, Star Hospitals, Road No. 10, Banjara Hills, Hyderabad, 500034, Telangana, India

    Lokeswara Rao Sajja

  2. Division of Clinical Research in Cardiovascular Medicine/Surgery, Sajja Heart Foundation, Srinagar Colony, Hyderabad, 500073, India

    Devanish Narasimhasanth Kamtam, Sateesh Kumar Sreeramula & Prashanthi Beri

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Correspondence to Lokeswara Rao Sajja.

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Ethical committee approval

This study complies with the principles of the Declaration of Helsinki and was approved by the institutional ethics committee dated 29 Oct. 2022 with the reference no.: SH/RS/IEC/2021– 2022/1012.

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The authors declare that there is no conflict of interest.

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The need for informed consent from the patient was waived off as this study does not involve patients’ participation.

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Sajja, L.R., Kamtam, D.N., Sreeramula, S.K. et al. Current practice of saphenous vein graft harvesting in coronary artery bypass graft surgery: an Indian survey. Indian J Thorac Cardiovasc Surg 39, 115–124 (2023). https://doi.org/10.1007/s12055-022-01441-z

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  • DOI: https://doi.org/10.1007/s12055-022-01441-z

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