A randomised controlled techniques saphenous vein harvest; morbidity lowering with minimally invasive technique

Abstract

Background: The long incision is associated with significant intra-operative and postoperative complications. The use of minimal invasive saphenous vein harvesting has been advocated in an effort to minimize such wound related problems. The objective of this study was to compare the morbidity associated with long saphenous vein harvesting using the traditional open technique (A) against a minimally invasive technique using the Mayo vein stripper (B) that involves multiple short incisions.Methods: Authors conducted a prospective randomized controlled study in 80 patients undergoing first time coronary artery bypass grafting. Pain and healing was assessed on each postoperative day. Rings of long saphenous vein were subjected to organ-bath evaluation of endothelium-dependent and endothelium-independent relaxation. Three patients were excluded from the study, leaving 38 patients in Group A and 39 in Group B.Results: With respect to operative procedure, Group A had a greater length of vein harvested than Group B. There was no statistical difference in pain scores and endothelium-dependent or endothelium-independent relaxation between the two groups. However, there were significantly more infections in Group A compared with Group B.Conclusions: Harvesting vein through multiple incisions using the Mayo vein stripper is quicker, results in fewer infections and has no deleterious effect on endothelial function compared to open technique.