OJTS  Vol.5 No.1 , March 2015
Morbidity of Open Saphenous Vein Harvesting after Preoperative Ultrasonic Mapping
ABSTRACT
Preoperative echography of a saphenous vein graft (SVG) was studied. In 58 cases of consecutive coronary artery bypass grafting, 31 patients underwent SVG echography. Preoperative assessment revealed vein caliber, branching, or varicose saphenous veins. The location of the saphenous vein was marked. Saphenous veins were harvested by the open harvest technique, and the caliber of the veins and the availability of the anastomosis device were recorded. Postoperative morbidity was recorded. Preoperative findings revealed that four (6.5%) of 62 femoral saphenous veins were estimated as “not graftable” because of being a varicose vein or having a small caliber. Seven of 32 lower saphenous veins were estimated as “not graftable”. The mean discrepancy of the caliber was 0.6 mm undersized with preoperative estimation. During harvesting, one of 31 patients had a wrong marking. We were able to use all harvested veins. The morbidity of saphenous harvesting was observed in two (6.5%) of 31 patients. One patient whose marking was wrong had minor skin necrosis. Another patient experienced a hematoma because of the excess effect of warfarin. Preoperative ultrasonic mapping of the saphenous vein reduced useless harvesting, provided information concerning anastomosis device availability, and seemed to reduce morbidity because dissection can be minimal.

Cite this paper
Isoda, S. , Kimura, T. , Tanaka, K. , Nishimura, K. , Yamanaka, N. , Taguchi, S. , Uchida, K. , Karube, N. and Imoto, K. (2015) Morbidity of Open Saphenous Vein Harvesting after Preoperative Ultrasonic Mapping. Open Journal of Thoracic Surgery, 5, 4-9. doi: 10.4236/ojts.2015.51002.
References
[1]   Luckrutz, H., Lowe, J., Pugh, N. and Azzu, A.A. (2008) Pre-Operative Long Saphenous Vein Mapping Predicts Vein Anatomy and Quality Leading to Improved Post-Operative Leg Morbidity. Interactive CardioVasc Thoracic Surgery, 7, 188-191.
http://dx.doi.org/10.1510/icvts.2007.166645

[2]   Athanasiou, T., Aziz, O., Skapinakis, P., et al. (2003) Leg Wound Infection after Coronary Artery Bypass Grafting: A Meta-Analysis Comparing Minimally Invasive versus Conventional Vein Harvesting. The Annals of Thoracic Surgery, 76, 2141-2146.
http://dx.doi.org/10.1016/S0003-4975(03)01435-8

[3]   Puskas, J.D., Wright, C.E., Miller, P.K., et al. (1999) A Randomized Trial of Endoscopic versus Open Saphenous Vein Harvest in Coronary Bypass Surgery. The Annals of Thoracic Surgery, 68, 1509-1512.
http://dx.doi.org/10.1016/S0003-4975(99)00952-2

[4]   Aziz, O., Athanasiou, T. and Darzi, A. (2006) Minimally Invasive Conduit Harvesting: A Systematic Review. European Journal Cardio-Thoracic Surgery, 29, 324-333.
http://dx.doi.org/10.1016/j.ejcts.2005.11.032

[5]   Amano, J., Kuwano, H. and Yokomise, H. (2013) Thoracic and Cardiovascular Surgery in Japan during 2011. Annual Report by the Japan Association for Thoracic Surgery. General Thoracic and Cardiovascular Surgery, 61, 576-607.
http://dx.doi.org/10.1007/s11748-013-0289-2

[6]   Carpino, P.A., Khabbaz, K.R., Bojar, R.M., et al. (2000) Clinical Benefits of Endoscopic Vein Harvesting in Patients with Risk Factors for Saphenectomy Wound Infections Undergoing Coronary Artery Bypass Grafting. The Journal of Thoracic and Cardiovascular Surgery, 119, 69-75.
http://dx.doi.org/10.1016/S0022-5223(00)70219-4

[7]   Dacey, L.J., Braxton Jr., J.H., Kramer, R.S., et al. (2011) Long-Term Outcomes of Endoscopic Vein Harvesting after Coronary Bypass Grafting. Circulation, 123, 147-153.
http://dx.doi.org/10.1161/CIRCULATIONAHA.110.960765

[8]   Ouzounian, M., Hassan, A., Buth, K.J., et al. (2010) Impact of Endoscopic versus Open Saphenous Vein Harvest Techniques on Outcomes after Coronary Artery Bypass Grafting. The Annals of Thoracic Surgery, 89, 403-408.
http://dx.doi.org/10.1016/j.athoracsur.2009.09.061

[9]   Kai, M., Hanyu, M., Soga, Y., Nomoto, T., Nakano, J., Matsuo, T., et al. (2009) Midterm Patency Rate after Saphenous Vein Grafting with a PAS-Port Device. The Journal of Thoracic and Cardiovascular Surgery, 137, 503-504.
http://dx.doi.org/10.1016/j.jtcvs.2008.03.006

 
 
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