Pedicled Vein Grafts in Coronary Surgery: Perioperative Data From a Randomized Trial
| Autor: | Anders Winnerkvist, Dag Nordhaug, Maryann Stenvik, Rune Wiseth, Knut Hegbom, Asbjørn Karevold, Per Magnus Haram, Øystein Pettersen, Alexander Wahba |
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| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Intimal hyperplasia business.industry medicine.medical_treatment Extracorporeal circulation Percutaneous coronary intervention Perioperative 030204 cardiovascular system & hematology medicine.disease Surgery Transplantation 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Occlusion medicine 030212 general & internal medicine Cardiology and Cardiovascular Medicine business Vein Artery |
| Zdroj: | The Annals of Thoracic Surgery. 104:1313-1317 |
| ISSN: | 0003-4975 |
| Popis: | Background Less-than-optimal long-term patency of the saphenous vein is one of the main obstacles for the success of coronary artery bypass grafting (CABG). Results from the IMPROVE-CABG trial has shown that harvesting the saphenous vein with a pedicle of perivascular tissue less than 5 mm while using manual distention provides comparable occlusion rates but significantly less intimal hyperplasia at early follow-up. The impact of pedicled veins on duration of operations, leg wound infections, and postoperative bleeding is unknown. Methods One hundred patients undergoing first-time elective CABG were randomly assigned to conventional or pedicled vein harvesting. Perioperative and postoperative data were collected prospectively during the hospital stay and at follow-up. Results Duration of extracorporeal circulation was significantly longer in the pedicled vein group (mean: 76 min versus 65 min, p = 0.006); however, no significant difference was found in the cross-clamp time. No significant difference was found in intraoperative vein graft flow, postoperative bleeding, or leg wound infections (4% in each group). No reoperations were due to vein graft bleeding. Conclusions Harvesting a pedicled vein provides comparable postoperative bleeding and leg wound infection rates in selected patients. The technique is associated with a slightly longer duration of extracorporeal circulation than harvesting conventional veins. Promising early results using the pedicled vein technique may contribute to a change in standard vein harvesting technique for CABG in selected patients. |
| Databáze: | OpenAIRE |
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