Endoscopic Versus Open Saphenous Vein Harvesting in Coronary Artery Bypass Grafting

Sanjeeve  Kumar Garg; Hesham  Sabry Abdelsabour; Bassem  Abdelgawad; Ihab Omar Kamel

Sanjeeve Kumar Garg Department of Cardiothoracic Surgery, Sultan Qaboos Hospital, Salalah, Oman
Hesham Sabry Abdelsabour Department of Cardiothoracic Surgery, Sultan Qaboos Hospital, Salalah, Oman
Bassem Abdelgawad Department of Cardiothoracic Surgery, Faculty of Medicine, Benha University, Egypt
Ihab Omar Kamel Department of Cardiothoracic Surgery, Faculty of Medicine, Beni-Suef University, Egypt ; Department of Cardiothoracic Surgery, Sultan Qaboos Hospital, Salalah, Oman

Keywords: Endoscopic vein harvesting, Minimally invasive surgery, Great saphenous vein, Coronary artery bypass grafting

Abstract

Background: Endoscopic saphenous vein grafting has been acknowledged as a valuable method for mitigating postoperative wound scarring and associated problems.

Methods: We reviewed 60 patients who underwent coronary artery bypass surgery and had their vein graft harvested by open (OVH A, n = 30) versus endoscopic (EVH, n = 30) technique. Both groups were matched for age and sex. Wound complications were determined by the presence of ecchymosis, hematoma, keloids, dehiscence, infection, and the need for intervention. The time of harvesting was recorded routinely for each patient.

Results: When comparing open and endoscopic techniques for harvesting saphenous veins, ecchymosis was more in EVH, while wound dehiscence was more in the OVH group. Surprisingly, no significant difference between both groups regarding other wound problems, including purulent discharge. On follow-up, both groups did not show any significant difference in terms of readmissions for leg wound complications, need for plastic surgery, cosmetic satisfaction, bleeding, or recurrence of angina.

Conclusion: Endoscopic technique was associated with increased ecchymosis and reduced wound dehiscence incidence.