Endoscopic saphenous vein harvesting: Initial experience and learning curve

Background. Saphenous vein remains an elective conduit for up to 85% of coronary bypass operations. It is obtained through one or numerous skin incisions, with a reported morbidity varying from 5% to 25%. The endoscopic vein harvesting (EVH) technique was developed to minimize this morbidity and to...

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Autor principal: Vrancic, J.M
Otros Autores: Piccinini, F., Vaccarino, G., Iparraguirre, E., Albertal, J., Navia, D.
Formato: Capítulo de libro
Lenguaje:Inglés
Publicado: 2000
Acceso en línea:Registro en Scopus
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Registro en la Biblioteca Digital
Aporte de:Registro referencial: Solicitar el recurso aquí
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100 1 |a Vrancic, J.M. 
245 1 0 |a Endoscopic saphenous vein harvesting: Initial experience and learning curve 
260 |c 2000 
270 1 0 |m Vrancic, J.M.; Department of Cardiovascular Surgery, Inst. Cardiovascular de Buenos Aires, Blanco Encalada 1543, 1428 Buenos Aires, Argentina; email: don@lvd.com.ar 
506 |2 openaire  |e Política editorial 
504 |a DeLaria, G.A., Hunter, J.A., Goldin, M.D., Serry, C., Javid, H., Najafi, H., Leg wound complications associated with coronary revascularization (1981) J Thorac Cardiovasc Surg, 81, pp. 403-407 
504 |a Utley, J.R., Thomason, M.E., Wallace, D.J., Preoperative correlates of impaired wound healing after saphenous vein incision (1989) J Thorac Cardiovasc Surg, 98, pp. 147-149 
504 |a Crouch, J.A., Keuler, J., Kleinman, L., (1998), pp. 981-985. , Endoscopic saphenous vein harvesting for coronary artery bypass grafting. Monduzzi Editore, 6th World Congress Endoscopic Surgery. Rome, June 3-6 1998; Pagni, S., Ulfe, E., Montgomery, W., Clinical experience with the video-assisted saphenectomy procedure for coronary bypass operations (1998) Ann Thorac Surg, 66, pp. 1626-1631 
504 |a Crouch, J., O'Hair, D., Keuler, J., Barragry, T., Werner, P., Kleinman, L., Open versus endoscopic saphenous vein harvesting: Wound complications and vein quality (1999) Ann Thorac Surg, 68, pp. 1513-1516 
504 |a Allen, K., Griffith, G., Heimansohn, D., Endoscopic versus traditional saphenous vein harvesting: A prospective, randomized trial (1998) Ann Thorac Surg, 66, pp. 26-32 
504 |a Puskas, J., Wright, C., Miller, P., A randomized trial of endoscopic versus open saphenous vein harvest in coronary bypass surgery (1999) Ann Thorac Surg, 68, pp. 1509-1512 
520 3 |a Background. Saphenous vein remains an elective conduit for up to 85% of coronary bypass operations. It is obtained through one or numerous skin incisions, with a reported morbidity varying from 5% to 25%. The endoscopic vein harvesting (EVH) technique was developed to minimize this morbidity and to improve clinical outcomes. The aim of this study was to review the feasibility of this method, its learning curve, and changing results in a group without previous experience in this procedure. Methods. Between July 1998 and October 1999, 179 patients for coronary artery bypass grafting underwent EVH (Vasoview Guidant, USA 'double access' and Uniport), by two operators. Results were reported based on time of harvesting, length of conduits, technical details, and clinical outcomes, and divided into six groups of 30 consecutive patients each. Results. Patient demographics were as follows: 86.03% were male, aged 64.3 ± 9.12 years (range, 43 to 92 years), with diabetes mellitus in 28.49%, obesity in 18.43%, and vascular disease in 11.17%. The EVH method was limited to the thigh in 77.65% of cases and extended to the leg in 22.35%. Patients received an average of 2.45 ± 0.58 incisions and obtained conduits had a mean length of 34.96 ± 9.65 cm (range, 15 to 70 cm). The number of venous bypasses per patient was 1.30 ± 0.59. Mean time of EVH was 47.24 ± 19.84 minutes (range, 15 to 120), with a length-time index of 0.85 ± 0.36. Primary success was achieved in 95.54%, with crossover to open technique in 4.46%. General morbidity was 8.9%, with hematoma in 1.11%, skin necrosis in 1.11%, infection in 6.7%, and readmission in 1.11%. Conclusions. Endoscopic vein harvesting is a feasible and reproductible method, with a typical learning curve, acceptable morbidity, and unquestionable benefits for coronary artery bypass graft patients.(C) 2000 by The Society of Thoracic Surgeons.  |l eng 
593 |a Department of Cardiovascular Surgery, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina 
593 |a Department of Cardiovascular Surgery, Instituto Cardiovascular de Buenos Aires, Blanco Encalada 1543, 1428 Buenos Aires, Argentina 
690 1 0 |a ADULT 
690 1 0 |a AGED 
690 1 0 |a CONFERENCE PAPER 
690 1 0 |a CORONARY ARTERY BYPASS GRAFT 
690 1 0 |a DEVICE 
690 1 0 |a ENDOSCOPIC SURGERY 
690 1 0 |a EXPERIENCE 
690 1 0 |a FEMALE 
690 1 0 |a HEMATOMA 
690 1 0 |a HUMAN 
690 1 0 |a INFECTION 
690 1 0 |a LEARNING 
690 1 0 |a MAJOR CLINICAL STUDY 
690 1 0 |a MALE 
690 1 0 |a MORBIDITY 
690 1 0 |a PRIORITY JOURNAL 
690 1 0 |a SAPHENOUS VEIN 
690 1 0 |a SKIN INCISION 
690 1 0 |a SKIN NECROSIS 
690 1 0 |a SURGICAL TECHNIQUE 
690 1 0 |a VASCULAR ACCESS 
690 1 0 |a VEIN BYPASS 
690 1 0 |a ADULT 
690 1 0 |a AGED 
690 1 0 |a AGED, 80 AND OVER 
690 1 0 |a CORONARY ARTERY BYPASS 
690 1 0 |a DIABETES MELLITUS 
690 1 0 |a ENDOSCOPY 
690 1 0 |a FEASIBILITY STUDIES 
690 1 0 |a FEMALE 
690 1 0 |a HUMAN 
690 1 0 |a MALE 
690 1 0 |a MIDDLE AGE 
690 1 0 |a OBESITY 
690 1 0 |a SAPHENOUS VEIN 
690 1 0 |a SURGICAL PROCEDURES, MINIMALLY INVASIVE 
690 1 0 |a VASCULAR DISEASES 
700 1 |a Piccinini, F. 
700 1 |a Vaccarino, G. 
700 1 |a Iparraguirre, E. 
700 1 |a Albertal, J. 
700 1 |a Navia, D. 
773 0 |d 2000  |g v. 70  |h pp. 1086-1089  |k n. 3  |p Ann. Thorac. Surg.  |x 00034975  |t Annals of Thoracic Surgery 
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