Long-term graft patency of saphenous vein grafts after endoscopic harvest in patients after aortocoronary bypass grafting.
Dr. Okaikor Okantey1,3, Dr. Tomáš Jonszta2,3, Dr. Jiří Sieja1,3, Dr. Miriam Kende1,3, Dr. Radím Brát1,3, Ing. Lubomír Pavliska4
1Department of Cardiac Surgery, University Hospital Ostrava, Ostrava, Ostrava, Czech Republic, 2Department of Radiology, University Hospital Ostrava, Ostrava, Czech Republic, 3Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic, 4Department of Science and Research, University Hospital Ostrava, Ostrava, Czech Republic
Objectives: Endoscopic vein harvest of the greater saphenous vein for aortocoronary bypass grafting presents a newer and less invasive mode of vein harvest that is rapidly becoming a popular approach used in the field of cardiac surgery. This study aimed to compare the long-term patency of saphenous vein grafts (a minimum of 10 years) after endoscopic harvest with open vein harvest in patients after isolated surgical myocardial revascularization and clinical outcomes.
Methods: Fifty patients (25 after endoscopic and 25 after open harvest) who underwent myocardial revascularization between 2009 and 2011 at the University Hospital Ostrava were enrolled in the study. The study comprised two phases: completion of questionnaires assessing recurring symptoms of ischemic heart disease and visualization of vein grafts via coronary computed tomography angiography to assess graft patency.
Results: The primary outcome showed higher rates of vein graft stenosis after endoscopic harvest (31.2% vs. 23.9%); however, the difference was not statistically significant (p = 0.706). Differences in clinical outcomes were not statistically significant regarding recurring angina (28% endoscopic group, 32% open group, p = 0.519), dyspnea (24% vs. 16%, p = 0.817), myocardial infarction, and catheter-based revascularization of grafts had the same results (8% endoscopic, 16% open, p = 0.734). Redo surgery was not reported in any of the cohorts.
Conclusion: Vein grafts harvested endoscopically and traditionally have similar long-term patency rates angiographically and clinically, thus presenting a safe and efficient mode of harvest for patients undergoing surgical myocardial revascularization.