Mid-term outcomes for Endoscopic versus Open Vein Harvest: a case control study.

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Procedures
• Grafting Techniques

Background:

• Saphenous vein is the primary conduit for coronary artery bypass grafting (CABG).
• Minimally invasive Endoscopic Vein Harvest (EVH) is increasingly used.
• Concerns exist regarding EVH's impact on long-term graft patency and survival compared to Open Vein Harvest (OVH).

Purpose of the Study:

• To compare patient outcomes and graft patency between EVH and OVH.
• To assess the safety and efficacy of minimally invasive vein harvesting in CABG.

Main Methods:

• Retrospective case-control study comparing EVH (n=89) and OVH (n=182).
• Primary endpoint: mortality. Secondary endpoints: adverse cardiac events, angina, wound complications, self-rated health.
• Analysis included Cox Log-Rank for mortality and assessment of repeat angiography data.

Main Results:

• No significant difference in all-cause mortality (EVH: 2%, OVH: 6%; p=0.65).
• Similar rates of freedom from angina, re-admission, and need for anti-anginals.
• Significantly lower leg wound complications with EVH (7%) vs. OVH (28%; p=0.0008).
• Higher patient self-rated health scores approached significance in the EVH group (p=0.06).

Conclusions:

• EVH demonstrates a significant reduction in wound complications.
• Preliminary results support offering EVH as a minimally invasive option.
• Further large-scale, prospective trials are needed to confirm long-term graft patency and patient outcomes.