Use of a purse string suture in proximal coronary anastomosis to reduce size mismatch between conduit and aortotomy

Abstract

Figure 1 Size mismatch between aortotomy and conduit; proximal anastomosis is performed using a continuous suture BACKGROUND The long saphenous vein (LSV) has been the most popular conduit for cardiac surgeons performing coronary artery bypass surgery. The traditional method of open dissection based on surface landmarks can result in morbidity (bleeding, infection, wound complications). This can be compounded in the obese patient where difficulties in locating the LSV can lead to extensive dissection and tissue damage.1 The use of endoscopic techniques to harvest the LSV is reported to reduce these morbidities but is yet to be established as routine practice.2 We describe a simple technique to augment the traditional open method by using ultrasound to mark the skin preoperatively at 3–5 points that overlie the LSV.