Document Detail


Open versus endoscopic saphenous vein harvesting: wound complications and vein quality.
MedLine Citation:
PMID:  10543557     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The saphenous vein is an important conduit for coronary artery bypass grafting. Wound complications from traditional open vein harvesting occur often. Minimally invasive endoscopic saphenous vein harvesting may decrease wound complications. Vein quality may be an issue with endoscopic harvesting. METHODS: We reviewed 568 patients who had bypass grafting and saphenous vein harvesting either endoscopic (group A, n = 180) versus open (group B, n = 388). Both groups were demographically similar and management identical. Wound complication was defined by the need for intervention and included lymphocele, hematoma, cellulitis, edema, eschar, and infection. Multiple vein segments were obtained from 8 patients, 4 from each group, and examined histologically. RESULTS: Wound complications were significantly less in group A (9/180, 5%) versus group B (55/388, 14.2%), p value equal to or less than 0.001. Open harvesting (p< or =0.001), diabetes (p< or =0.001), and obesity (p< or =0.02) were risk factors for wound complication by univariate analysis. By multiple logistic analysis, open harvesting (p< or = 0.0007) and diabetes (p< or =0.0001) were independent risk factors for wound infection. Histologic evaluation of vein samples showed that there was no difference between the groups and vascular structural integrity was maintained. CONCLUSIONS: Endoscopic saphenous vein harvesting was associated with fewer wound complications and infections. Vein quality was not adversely effected because of endoscopic harvesting.
Authors:
J D Crouch; D P O'Hair; J P Keuler; T P Barragry; P H Werner; L H Kleinman
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  68     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-11-09     Completed Date:  1999-11-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1513-6     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Surgery Associates SC, Milwaukee, Wisconsin 53215, USA. jcrouch@execpc.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Artery Bypass*
Endoscopy*
Female
Humans
Male
Middle Aged
Quality Assurance, Health Care
Risk Factors
Surgical Wound Infection / etiology*
Veins / transplantation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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