Clinicopathological comparisons of open vein harvesting and endoscopic vein harvesting in coronary artery bypass grafting patients in Mashhad

Ahmad Amouzeshi; Mohamad Abbassi Teshnisi; Nahid Zirak; Alireza Sepehri Shamloo; Hamid Hoseinikhah; Behzad Alizadeh; Aliasghar Moeinipour

doi:10.19082/1693

Clinicopathological comparisons of open vein harvesting and endoscopic vein harvesting in coronary artery bypass grafting patients in Mashhad

Electron Physician. 2016 Jan 15;8(1):1693-700. doi: 10.19082/1693. eCollection 2016 Jan.

Authors

Ahmad Amouzeshi¹, Mohamad Abbassi Teshnisi², Nahid Zirak³, Alireza Sepehri Shamloo⁴, Hamid Hoseinikhah⁵, Behzad Alizadeh⁶, Aliasghar Moeinipour⁷

Affiliations

¹ M.D., Assistant Professor, Department of Cardiac Surgery, Faculty of Medicine, Birjand University of Medical Science, Birjand, Iran.
² M.D., Associate Professor, Department of Cardiac Surgery, Faculty of Medicine, Atherosclerosis Prevention Research Center, Imam Reza Hospital, Mashhad University of Medical Science, Mashhad, Iran.
³ M.D., Associate Professor, Department of Anesthesiology, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Science, Mashhad, Iran.
⁴ Medical Student, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
⁵ M.D., Assistant Professor, Department of Cardiac Surgery, Atherosclerosis Prevention Research Center, Imam Reza Hospital, Mashhad University of Medical Science, Mashhad, Iran.
⁶ M.D., Assistant Professor, Department of Pediatric Cardiology, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Science, Mashhad, Iran.
⁷ M.D., Assistant Professor, Department of Cardiac Surgery, Faculty of Medicine, Atherosclerosis Prevention Research Center, Imam Reza Hospital, Mashhad University of Medical Science, Mashhad, Iran.

PMID: 26955438
PMCID: PMC4768916
DOI: 10.19082/1693

Abstract

Introduction: Harvesting of the greater saphenous vein is almost an inevitable part of coronary artery bypass grafting (CABG) operations, and it is done by two main techniques, i.e., conventional or open vein harvesting (OVH) and the minimally-invasive endoscopic vein harvesting (EVH). This study aimed to compare these two techniques in off-pump CABG procedures with respect to clinical and pathological outcomes.

Methods: This cohort study was conducted on CABG candidates during a one-year period from October 2013 through September 2014 in the Department of Cardiac Surgery at Mashhad University of Medical Sciences. Eighty-seven patients voluntarily underwent EVH, and another 86 patients matched for age, gender, and other cardiovascular risk factors were selected for OVH. They were followed up for six weeks, and the main outcome measures were infections of the wound, pain, duration of hospital stay, and the costs of hospitalization. Paired sample t-test, independent t-test, or their non-parametric equivalents and the chi-squared test were used by SPSS version 17.0 for data analysis.

Results: The mean duration of time for vein harvesting was shorter in the EVH group (p < 0.001), and the pain score was lower (p = 0.04). No infections occurred at the site of the wound. The length of hospital stay was not significantly different for the two groups (OVH versus EVH: 8.5 ± 3.3 versus 8.4 ± 3.2 days; p-value: 0.08). Hospitalization costs were significantly higher in the EVH group (OVH versus EVH: 5.8 ± 4.7 versus 7.3 ± 2.0 million Tomman; p-value: 0.008), yet no difference was diagnosed with respect to endothelial damage in the vein grafts harvested by the EVH and OVH techniques.

Conclusion: EVH is considered as a minimally invasive and safe vein harvesting technique in our Center, and it can reduce the harvesting time and post-operative pain. In addition, its efficiency was similar to that of OVH.

Keywords: clinical outcome; coronary artery bypass grafting; endoscopic vein harvesting; graft patency; open vein harvesting; pathological outcome.