title: Endoscopic Versus "No-Touch" Saphenous Vein Harvesting for Coronary Artery Bypass Grafting: A Trade-Off Between Wound Healing and Graft Patency.
abstract: The advantage in terms of wound infection, wound healing, and scarring has resulted in the recent adoption of endoscopic vein harvesting (EVH) as a standard of care for coronary artery bypass grafting in some centers. However, concerns regarding the quality of these grafts have been raised after recent evidence of decreased graft patency, increased reoperation rate, and myocardial infarct, problems that are associated with vascular trauma caused when using this technique. Simultaneously, an atraumatic, "no-touch" technique for harvesting the saphenous vein was developed producing grafts with improved patency comparable to the internal thoracic artery. However, wound complications remain a problem using this technique. This review outlines the need to consider the poor graft quality that may result from EVH and raises the question what is likely to be the "best practice principle" in saphenous vein harvesting?
authors.affiliation: University of Zagreb School of Medicine, Department of Cardiac Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.
authors.forename: Tomislav
authors.initials: T
authors.lastname: Kopjar
authors.affiliation: Surgical and Interventional Sciences, Royal Free Hospital Campus, University College Medical School, London, United Kingdom m.dashwood@ucl.ac.uk mickeydash@hotmail.com.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Dashwood
mesh_terms: D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000191:economics; D003324:Coronary Artery Disease / Q000191:economics / Q000601:surgery*; D003362:Cost-Benefit Analysis; D004724:Endoscopy / Q000009:adverse effects / Q000191:economics; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D017048:Health Care Costs; D006801:Humans; D012307:Risk Factors; D012501:Saphenous Vein / Q000503:physiopathology / Q000637:transplantation*; D013530:Surgical Wound Infection / Q000209:etiology; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D016896:Treatment Outcome; D014654:Vascular Patency; D014945:Wound Healing
keywords: coronary artery bypass grafting; endoscopic vein harvesting; no-touch vein harvesting; saphenous vein patency; vascular damage