Simultaneous endoscopic radial artery and great saphenous vein harvesting for redo coronary artery bypass grafting. A report of two cases

Martin Simek,Pavel Marcian,Petr Nemec,Marek Gwozdziewicz,Ivo Fluger

doi:10.5507/bp.2007.049

Abstract

An ageing population and increase in patient co-morbidities are forcing cardiac surgeons to meticulously consider the benefits and risks of respective conduits and their harvesting techniques. Two cases of simultaneous endoscopic radial artery and great saphenous vein harvesting, for redo coronary artery bypass grafting, are presented. A shortage of venous conduits after previous bypass grafting, as well as the presentation of several risk factors of wound-healing complications, favoured simultaneous utilisation of both endoscopic techniques. Endoscopic vessel harvesting together with the pre-harvesting duplex study is able to gain not only high-quality conduits but also minimize the risk of wound-healing and neurological disturbances associated the saphenous vein and radial artery harvesting.

Highlights

Endoscopic vessel harvesting for coronary artery bypass grafting (CABG) is a safe and reliable method[1, 2]
Endoscopic radial artery (ERAH) and great saphenous vein harvesting (EVH) techniques are associated with a significant reduction in wound-healing and neurological complications as well as less pain and better cosmetic results in comparison with traditional harvesting[1,2,3]
Simultaneous endoscopic harvesting of the great saphenous vein and radial artery unifies the advantages of both endoscopic procedures and can be carried out either by two surgeons utilizing two endoscopic devices at the same time, or by one surgeon performing harvesting successively with one endoscopic instrument

Summary

Introduction

Endoscopic vessel harvesting for coronary artery bypass grafting (CABG) is a safe and reliable method[1, 2]. Simultaneous endoscopic harvesting of the great saphenous vein and radial artery unifies the advantages of both endoscopic procedures and can be carried out either by two surgeons utilizing two endoscopic devices at the same time, or by one surgeon performing harvesting successively with one endoscopic instrument. In both cases presented bellow, the endoscopic vessel harvesting was carried out by one surgeon, the EVH followed the ERAH. The system using CO insufflation was used (Vasoview 6TM, Boston Scientific/Guidant, Diegelen, Belgium) and a pneumatic tourniquet was applied to secure forearm ischemia during ERAH (ref.[4])

Objectives

Discussion

Conclusion