Application of Endoscopic Vein Harvesting in Obese Patients Undergoing Coronary Artery Bypass Grafting

Curr Med Sci. 2018 Aug;38(4):691-696. doi: 10.1007/s11596-018-1932-z. Epub 2018 Aug 20.

Abstract

This study aims to evaluate the clinical outcomes of endoscopic vein harvesting (EVH) for coronary artery bypass grafting (CABG) in obese patients. Totally, 153 obese patients who underwent EVH (n=81) or standard bridging technique (SBT, n=12) in CABG surgery from May 2012 to October 2014 in our hospital were enrolled in this retrospective non-randomized controlled study. The general situation of operation, postoperative complications and short medium-term outcomes were analyzed. The baseline characteristics were similar between these two groups (P>0.05). There were no statistical differences in total operation time (226±28 min vs. 224±30 min, P>0.05), number of damaged vessels (0.12±0.05 vs. 0.16±0.06,P>0.05) and short medium-term outcomes including revascularization rate (1.25% vs. 2.78%, i 0.05), vessel dysfunction rate (11.25% vs. 11.11%,P>0.05) and mortality (0.00% v . 0.00%, P>0.05). Use of EVH was associated with significant reduction of total harvesting time (41 ±6 min vs. 63± 11 min, P<0.05), incision length (4.4±1.1 cm 18.2±4.5 cm, P<0.05) and postoperative lower extremity complications (P<0.05). EVH can reduce the risk of wound complications, whereas does not influence short- and medium-term outcomes in obese patients. It can be considered a reliable procedure of harvesting vessel conduits for obese patients undergoing CABG.

Keywords: coronary artery bypass grafting; minimally invasive endoscopy; obesity; saphenous vein harvesting.

Publication types

  • Comparative Study

MeSH terms

  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / methods*
  • Endoscopy / adverse effects
  • Endoscopy / methods*
  • Female
  • Graft Occlusion, Vascular / epidemiology*
  • Graft Occlusion, Vascular / etiology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / complications
  • Myocardial Ischemia / surgery
  • Obesity / complications
  • Obesity / surgery*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Saphenous Vein / surgery*
  • Tissue and Organ Harvesting / adverse effects
  • Tissue and Organ Harvesting / methods*
  • Transplantation, Autologous