Endoscopic Long Saphenous Vein Harvest from Femoralsite to Below the Knee through a Single Small Incision for Minimally Invasive Coronary Artery Bypass Grafting
Mizumoto, M.; Uchida, T.; Gomi, S.; Hamasaki, A.; Kuroda, Y.; Yamashita, A.; Hayashi, J.; Takahashi, A.; Watanabe, D.; Sadahiro, M.
Kyobu Geka. Japanese Journal of Thoracic Surgery 68(1): 35-40
2015
ISSN/ISBN: 0021-5252 PMID: 25595159 Document Number: 681138
Endoscopic saphenous vein harvest( EVH) for coronary artery bypass grafting( CABG) has been proved to be effective in reduced wound complications without compromising graft patency and mortality. Although EVH was usually performed from femoral site, we performed endoscopic long saphenous vein harvest( ELSH) from femoral to below the knee through a single small incision. There were few reports in EVH from below the knee and ELSH. Between September 2012 and June 2014, 13 patients who underwent ELSH in CABG. We assessed the initial evaluation in ELSH using the VirtuoSaph system. ELSH was performed by our unified procedure protocol to harvest good saphenous vein graft. The success rate of ELSH was 100% (13/13). The harvest time was 83.6±15.2 min, graft length was 52.1±5.6 cm, and number of side branches requiring repair was 2.6±1.6. Beating CABG was performed in all patients. The number of distal anastomoses was 3.8±0.8. Sequential bypass was 12 in total 23 saphenous vein grafts. The early patency was 95% (18/19 grafts) as evaluated by postoperative angiography or coronary enhanced computed tomography. All patients except 1( hospital death)were discharged without major or wound complications. The acceptable results and outcomes were demonstrated by our ELSH procedure protocol. ELSH is considered to be a feasible procedure to harvest enough graft length for 2 CABG and keep the other side of saphenous vein graft intact.