Endoscopic Vein Harvesting in Diabetic Patients Undergoing Coronary Artery Bypass Grafting: A Prospective Controlled Trial_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

MENG Wei , ZHU Da , XIAO Zhenghua

Department of Cardiovascular Surgery，West China Hospital of Sichuan University，Chengdu 610041，P. R. China;

Corresponding author：

Keywords：

Minimally invasive endoscopy; Great saphenous vein; Diabetes; Coronary artery bypass grafting Foundation item： National Natural Science Foundation of China（81170288）

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Abstract： Objective To evaluate clinical outcomes of endoscopic vein harvesting （EVH）for coronary artery bypass grafting（CABG） in diabetic patients. Methods In this prospective non-randomized control study, patients with type 2 diabetes who underwent CABG from December 2010 to Febuary 2012 in West China Hospital were enrolled. Based on different vein graft harvesting technique, these patients were divided into two groups: an EVH group and a conventional vein harvesting（CVH）group. Perioperative complications were compared between the two groups. Interventional or CT coronary angiogram was used to evaluate bypass graft patency during follow-up. Results A total of 51 patients with type 2 diabetes were enrolled in this study with 24 patients in the EVH group and 27 patients in the CVH group. There was no statistical difference in age, weight, and comorbidities between the two groups. There was no statistical difference in cardiopulmonary bypass time and aortic cross-clamping time between the two groups （67.2±9.8 min versus 68.3±14.5 min, P＞0.05; 62.4±11.3 min versus 65.2±10.3 min, P＞ 0.05）. The vein graft harvesting time （35.6±6.4 min versus 45.2±11.4 min, P＜ 0.05）and rate of delayed leg wound healing（0.0% with 0/24 versus 18.5% with 5/27, P＜0.05） of the EVH group were significantly shorter or lower than those of CVH group.There was no statistical difference in major postoperative complications with respect to venous graft failure rate and chest pain during short term follow-up（9.1 months in the CVH group and 9.4 months in the EVH group） between the two groups. Conclusion EVH is a safe, effective, minimally invasive and quick vein graft harvesting technique for CABG in diabetic patients.

Citation： MENG Wei,ZHU Da,XIAO Zhenghua,et al.. Endoscopic Vein Harvesting in Diabetic Patients Undergoing Coronary Artery Bypass Grafting: A Prospective Controlled Trial. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(3): 258-261. doi: Copy

1.	蒙炜，石应康，程述森，等. 冠状动脉旁路移植术166例临床分析. 中国胸心血管外科临床杂志， 2007， 14 （4）：312-313．.
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4.	Allen K， Cheng D， Cohn W， et al. Endoscopic vascular harvest in coronary artery bypass grafting surgery：a consensus statement of the International Society of Minimally Invasive Cardiothoracic Surgery （ISMICS） 2005. Innovations（Phila）， 2005， 1 （2）：51-60.
5.	Paletta CE， Huang DB， Fiore AC， et al. Major leg wound complications after saphenous vein harvest for coronary revascularization. Ann Thorac Surg， 2000， 70 （2）：492-497.
6.	Black EA， Campbell RK， Channon KM， et al. Minimally invasive vein harvesting significantly reduces pain and wound morbidity. Eur J Cardiothorac Surg， 2002， 22 （3）：381-386.
7.	Allen KB， Heimansohn DA， Robison RJ， et al. Influence of endoscopic versus traditional saphenectomy on event-free survival：five-year follow-up of a prospective randomized trial. Heart Surg Forum， 2003， 6 （6）：E143-E145.
8.	Bonde P， Graham AN， Macgowan SW. Endoscopic vein harvest：advantages and limitations. Ann Thorac Surg， 2004， 77 （6）：2076-2082.
9.	Rousou LJ， Taylor KB， Lu XG， et al. Saphenous vein conduits harvested by endoscopic technique exhibit structural and functional damage. Ann Thorac Surg， 2009， 87 （1）：62-70.

1. 　蒙炜，石应康，程述森，等. 冠状动脉旁路移植术166例临床分析. 中国胸心血管外科临床杂志， 2007， 14 （4）：312-313．.
2. 　Eagle KA， Guyton RA， Davidoff R， et al. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery:a report of the American College of　Cardiology/American Heart Association Task Force on Practice Guidelines （Committee to Up-date the 1999 Guidelines for Coronary Artery Bypass Graft　Surgery）. Circulation， 2004， 110 （14）：e340-e437.
3. 　Allen KB， Heimansohn DA， Robison RJ， et al. Risk factors for leg wound complications following endoscopic versus traditional saphenous vein　harvesting. Heart Surg Forum， 2000， 3 （4）：325-330.
4. 　Allen K， Cheng D， Cohn W， et al. Endoscopic vascular harvest in coronary artery bypass grafting surgery：a consensus statement of the International Society of Minimally Invasive Cardiothoracic Surgery （ISMICS） 2005. Innovations（Phila）， 2005， 1 （2）：51-60.
5. 　Paletta CE， Huang DB， Fiore AC， et al. Major leg wound complications after saphenous vein harvest for coronary revascularization. Ann Thorac Surg， 2000， 70 （2）：492-497.
6. 　Black EA， Campbell RK， Channon KM， et al. Minimally invasive vein harvesting significantly reduces pain and wound morbidity. Eur J Cardiothorac Surg， 2002， 22 （3）：381-386.
7. 　Allen KB， Heimansohn DA， Robison RJ， et al. Influence of endoscopic versus traditional saphenectomy on event-free survival：five-year follow-up of a prospective randomized trial. Heart Surg Forum， 2003， 6 （6）：E143-E145.
8. 　Bonde P， Graham AN， Macgowan SW. Endoscopic vein harvest：advantages and limitations. Ann Thorac Surg， 2004， 77 （6）：2076-2082.
9. 　Rousou LJ， Taylor KB， Lu XG， et al. Saphenous vein conduits harvested by endoscopic technique exhibit structural and functional damage. Ann Thorac Surg， 2009， 87 （1）：62-70.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Endoscopic Vein Harvesting in Diabetic Patients Undergoing Coronary Artery Bypass Grafting: A Prospective Controlled Trial

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