Abstract
Great saphenous vein harvest is associated with a significant risk of impaired wound healing. The purpose of this study was to determine efficacy of one system designed for minimally invasive vein harvest (MIVH) and to assess postoperative and mid-term wound-healing disturbances. From February 2004 to June 2005, great saphenous harvest for coronary artery bypass grafting (CABG) was performed in a group of 120 consecutive patients employing the VEGA system (B/Braun-Aesculap, Tuttlingen, Germany). Patients were evaluated on 7th postoperative day, at the 3-month and 1-year follow-up for wound healing disturbances, residual leg edema, and saphenous neuropathy. The mean age was 67.3 years, male patients dominated (70%), and the leading procedure was CABG (83%). The mean number of harvested venous grafts was 1.9 ± 1.2 and the mean number of skin incisions was 3.7 ± 2.2. The mean total vein harvesting time was 40.2 ± 16.8 minutes. Satisfactory healing was achieved in 98% patients on 7th postoperative day and at the 3-month follow-up all wounds were completely healed. Saphenous neuralgia remained a significant cause of morbidity, although its incidence decreased from 25% presented on 7th postoperative day to 8% presented at 1-year follow-up. Likewise, the incidence of leg edema decreased from 34% on the 7th postoperative day to 7% at 1-year follow-up. Minimally invasive vein harvest is a safe method associated with a significant reduction of wound disturbances. The VEGA system appears to be suitable and effective equipment for MIVH. Nevertheless, residual edema and mainly saphenous neuropathy represent a relatively frequent cause of patient morbidity at the postoperative and mid-term follow-up.
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References
DD Wipke-Tevis NA Storrs P Skov V Carrieri-Kohlman (1996) ArticleTitleFrequency, manifestation and correlates of impaired healing of saphenous vein harvest incisions Heart Lung 25 108–116 Occurrence Handle8682681 Occurrence Handle10.1016/S0147-9563(96)80112-9 Occurrence Handle1:STN:280:DyaK283lvVCltg%3D%3D
CE Paletta DB Huang AC Fiore MT Swartz FL Rilloraza JE Gardner (2002) ArticleTitleMajor leg wound complications after saphenous vein harvest for coronary revascularization Ann Thorac Surg 70 492–497 Occurrence Handle10.1016/S0003-4975(00)01414-4
R Garland FA Frizelle BR Dobbs H Singh (2003) ArticleTitleA retrospective audit of long-term lower limb complications following leg vein harvesting for coronary artery bypass grafting Eur J Cardiothorac Surg 23 950–955 Occurrence Handle12829071 Occurrence Handle10.1016/S1010-7940(03)00116-7 Occurrence Handle1:STN:280:DC%2BD3szgtFGjsQ%3D%3D
J Mountney GAL Wilkinson (1999) ArticleTitleSaphenous neuralgia after coronary artery bypass grafting Eur J Cardiothorac Surg 16 440–443 Occurrence Handle10571092 Occurrence Handle10.1016/S1010-7940(99)00294-8 Occurrence Handle1:STN:280:DC%2BD3c%2FjsFyluw%3D%3D
T Athanasiou O Aziz S Al-Ruzzeh P Philippidis C Jones S Purkayastha (2004) ArticleTitleAre wound healing disturbances and length of hospital stay reduced with minimally invasive vein harvest? A meta-analysis Eur J Cardiothorac Surg 24 1–12
T Athanasiou O Aziz P Skapinakis B Perunovic J Hart MC Crossman (2003) ArticleTitleLeg wound infection after coronary artery bypass grafting: a meta-analysis comparing minimally invasive versus conventional vein harvest Ann Thorac Surg 76 2141–2146 Occurrence Handle14667670 Occurrence Handle10.1016/S0003-4975(03)01435-8
V Dusterhoft M Bauer S Buz B Schaumann R Hetzer (2001) ArticleTitleWound healing disturbance after vein harvesting for CABG. A randomized trial to compare the minimally invasive direct vision and traditional approach Ann Thorac Surg 72 2038–2043 Occurrence Handle11789790 Occurrence Handle10.1016/S0003-4975(01)03047-8 Occurrence Handle1:STN:280:DC%2BD38%2FmsVWlsQ%3D%3D
AM Fabricius A Diegeler N Doll H Weidenbach FW Mohr (2000) ArticleTitleMinimally invasive saphenous vein harvesting techniques: morphology and postoperative outcome Ann Thorac Surg 70 473–478 Occurrence Handle10969665 Occurrence Handle10.1016/S0003-4975(00)01370-9 Occurrence Handle1:STN:280:DC%2BD3cvmtFygsA%3D%3D
GL Griffith KB Allen BF Waller DA Heimansohn RJ Robison JJ Schier CJ Shaar (2000) ArticleTitleEndoscopic and traditional saphenous vein harvest: a histologic comparison Ann Thorac Surg 69 520–523 Occurrence Handle10735691 Occurrence Handle10.1016/S0003-4975(99)01364-8 Occurrence Handle1:STN:280:DC%2BD3c7pslOgug%3D%3D
LP Perrault H Jeanmart L Bilodeau J Lesperance JF Tanguay D Bouchard P Page M Carrier (2004) ArticleTitleEarly quantitative coronary angiography of saphenous vein grafts for coronary artery bypass grafting harvested by means of open versus endoscopic saphenectomy: a prospective randomized trial J Thorac Cardiovasc Surg 127 1402–1407 Occurrence Handle15115999 Occurrence Handle10.1016/j.jtcvs.2003.10.040 Occurrence Handle1:STN:280:DC%2BD2c3hvVSkug%3D%3D
Z Davis D Garber S Clark H Roth V Bufalino MJ Budoff (2004) ArticleTitleLong-term patency of coronary graft with endoscopically harvested veins determined by contrast-enhanced electron beam computed tomography J Thorac Cardiovasc Surg 127 823–828 Occurrence Handle15001912 Occurrence Handle10.1016/j.jtcvs.2003.10.051
KL Yun YX Wu V Aharonian P Mansukhani TA Pfeffer CF Sintek GS Kochamba G Grunkemeier S Knosari (2005) ArticleTitleRandomized trial of endoscopic versus open vein harvest for coronary artery bypass grafting: six-month patency rates J Thorac Cardiovasc Surg 129 488–490 Occurrence Handle10.1016/j.jtcvs.2004.11.030
KB Allen DA Heimansohn RJ Robinson JJ Schier GL Griffith EB Fitzgerald (2003) ArticleTitleInfluence of endoscopic versus traditional saphenectomy on event-free survival: five year follow-up of a prospective randomized trial Heart Surg Forum 6 E143–145 Occurrence Handle14722001
K Allen D Cheng W Cohn M Connoly J Edgerton V Falk J Martin T Ohtsuka R Vitali (2005) ArticleTitleEndoscopic vascular harvest in coronary artery bypass grafting surgery: a consensus statement of the International Society of Minimally Invasive Cardiothoracic Surgery (ISMICS) 2005 Innovations 1 51–60
M Cisowski M Wites W Geber A Gerber A Bochanek (2000) ArticleTitleMinimally invasive saphenous vein harvesting for coronary artery bypass grafting—comparison of three less invasive methods Med Sci Monitor 6 735–739 Occurrence Handle1:STN:280:DC%2BD3M7psVOnsw%3D%3D
M Šimek P Němec (2005) ArticleTitleMinimally invasive saphenous vein harvesting for coronary artery bypass grafting. Use of VEGA system Rozhl Chir 84 213–216 Occurrence Handle16045115
UR Nair G Griffiths RA Lawson (1988) ArticleTitlePost-operative neuralgia in the leg after saphenous vein coronary artery bypass graft: a prospective study Thorax 43 41–43 Occurrence Handle3281308 Occurrence Handle1:STN:280:DyaL1c7nvVGjsw%3D%3D Occurrence Handle10.1136/thx.43.1.41
O Aziz T Athanasiou A Darzi (2006) ArticleTitleMinimally invasive conduit harvesting: a systematic review Eur J Cardiothorac Surg 29 324–333 Occurrence Handle16387505 Occurrence Handle10.1016/j.ejcts.2005.11.032
D Cheng K Allen W Cohn M Connoly J Edgerton V Falk J Martin T Ohtsuka R Vitali (2005) ArticleTitleEndoscopic vascular harvest in coronary artery bypass grafting surgery: a meta-analysis of randomized trial and controlled trials Innovations 1 61–74
M Šimek V Bruk P Ne?mec P Šantavý I Fluger (2006) ArticleTitleEndoscopic saphenous vein harvesting for coronary artery bypass grafting Rozh Chir 85 211–215
Šimek M, Bruk V, Němec P (in press) Endoscopic saphenous vein harvesting for coronary artery bypass grafting. Post-operative and mid-term outcomes. Cor Vasa 48
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Šimek, M., Němec, P. Postoperative and mid-term wound disturbance outcomes of minimally invasive saphenous vein harvest using the VEGA system. Heart Vessels 22, 94–98 (2007). https://doi.org/10.1007/s00380-006-0949-6
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DOI: https://doi.org/10.1007/s00380-006-0949-6