The Early and Mid-term Outcomes of Endoscopic Saphenous Vein Harvesting in Coronary Artery Bypass Grafting

Shigefumi Matsuyama ¹, Tomohiro Imazuru ², Toshifumi Saga ¹, Tsukasa Ikeda ², Hiroo Ota ², Naomi Ozawa ², Mitsuru Iida ², Yosuke Kitanaka ¹, Tatsuya Nakao ¹, Tomoki Shimokawa ²

¹ Department of Cardiovascular Surgery, New Tokyo Hospital, Chiba, Matsudo, Japan; ² Department of Cardiovascular Surgery, Teikyo University Hospital, Tokyo, Japan;

Date, time and location: 2018.05.25 13:30, Congress Hall, 2F–A

Abstract

Objective: Endoscopic saphenous vein harvesting (EVH) has superior cosmetic results and fewer wound complications than conventional open vein harvesting (OVH), and has been reported to have satisfactory early clinical outcomes. However, mid-term outcomes after EVH remain controversial. This retrospective study, we analyzed the early and mid-term outcomes of EVH compared with OVH in patients with coronary artery bypass grafting (CABG).

Methods: Isolated CABG using a saphenous vein graft was performed in 320 patients at Teikyo university hospital between September 2009 and December 2016. One hundred forty-nine patients underwent EVH and 171 patients underwent OVH. Operative mortality, morbidity, early patency, wound complications, and 5-yr survival were compared in the two groups. Early patency rates were assessed using angiography or computed tomography in 265 patients (414 anastomoses).

Results: The number of bypass was larger and the operation time was longer in EVH group. The success rate of EVH was 100%. Operative mortality was 2.0% in the EVH group and 1.8% in the OVH group (p=0.59). The early patency of the vein graft was 89.4% in the EVH group and 90.2% in the OVH group (p=0.55). EVH was associated with a lower incidence of harvest site wound complications relative to OVH (0.6% vs. 11.1%, p<0.0001). Five-year survival was 82.7±5.2% in the EVH group and 78.3±4.3% in the OVH group (p=0.58). Five-year survival free from major adverse cerebro-cardiovascular events was 51.2±9.2% in the EVH group and 59.5±5.1% in the OVH group (p=0.17).

Conclusions: EVH decreased wound complications and had marked cosmetic advantages. The early and mid-term clinical outcomes of EVH were equivalent to those of OVH.