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Despite the widespread use of arterial grafts, the greater saphenous vein is still the most popular conduit for coronary artery bypass grafting.
Invasive procedures have garnered interest in recent years for vessel harvesting, and several studies have demonstrated that endoscopic vein-graft harvesting reduces postoperative pain and the length of hospital stay. in addition to obviating the requirement for a lengthy longitudinal incision
Endoscopic Vein harvesting for CABG treatment
To ensure adequate long-term performance and acceptable patient outcomes, the blood vessel that will be used in coronary artery bypass graft surgery must be germ-free.
In fact, the quality of the conduit plays a significant role in long-term patient outcomes.
When inspecting the exterior of the harvested vessel, the conduit's condition is not always visible.
Endothelium damage, which occurs on the inside of the vessel, has been demonstrated to increase the risk of graft occlusion or blockage
Endoscopic Vein harvesting for CABG treatment - During Procedure
During EVH, a 3 cm incision on the medial side of the knee is used to harvest around 35 cm of the upper leg GSV using reusable devices.
The complete GSV can be harvested with a single incision after repeating the process in the other direction.
Many systems are available, however the disposable systems, such as Maquet'sVasoview, Terumo'sVirtuoSaph, and Sorin'sClearglide, are the most commonly utilised.
EVH technologies have become more accessible over time, but there is still a large personal and institutional learning curve.
The average procedural duration of the first 50 instances was 68 minutes, according to an analysis of 1348 patients who had had EVH. while the procedural time decreased drastically to 23 minutes in the last 200 cases. In general, the patient can expect a personal learning curve of 20-100 procedures that depend upon surgical experience.
Following Endoscopic Vein Harvesting for CABG treatment, normal procedures for preventing SV harvest site infection should be followed.
These may involve rigorous skin preparation, antimicrobial prophylaxis before to surgery, the use of suitable surgical methods, and wound care.
To prevent the modifiable causes of GSVHSI, it is critical to recognise the risk factors and act on them as soon as possible.
Diabetes is the most common risk in the EVH group, followed by peripheral vascular disease.
In the EVH group, valve surgery was used in 29% of the surgeries, which was much fewer than in the open vein harvest group.
The greater number of aortic valve replacements in the traditional vein harvesting group was the reason for this.