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.
Highlights
The saphenous vein graft (SVG) is a commonly used conduit for coronary artery bypass surgery [1]
Preoperative saphenous vein graft (SVG) echography was performed in 31 elective patients; this procedure was not available for emergent or urgent patients because the echographer was not available in emergent or urgent situation
There was no saphenous vein harvesting morbidity associated with a delay in hospital discharge
Summary
The saphenous vein graft (SVG) is a commonly used conduit for coronary artery bypass surgery [1]. Saphenous vein harvesting for coronary bypass surgery is associated with significant morbidity. The morbidity associated with open harvesting is reportedly approximately 14% on average and ranges 3% - 34% [2] [3]. The morbidity associated with minimally invasive vein harvesting is reportedly approximately 3.5% on average and ranges 0% 8% [2] [3]. A saphenous vein graft is harvested by the open technique. The aim of this study was to assess the usefulness of preoperative ultrasonic saphenous vein mapping before surgery in conduit quality, conduit location, and reducing postoperative morbidity
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