Clinical Results of Endoscopic Vein Harvesting During Coronary Artery Bypass Surgery

Introduction: endoscopic vein harvesting during myocardial revascularization reduces the risk of complications in the lower extremities, but is associated with a high risk of venous bypass damage and its dysfunction.

Аim: to evaluate the clinical results after endoscopic and open vein harvesting within 5 years of follow-up after surgery.

Materials and methods: in the cardiac surgery department No. 1 of the Research Institute of Cardiology, 344 coronary artery bypass grafting operations were performed from 2014 to January 2024 using the endoscopic method of vein harvesting using the Karl Storz endoscopic stand (Germany). Of these, 170 patients were included in the main group of postoperative observation (group 1), and 174 patients were included in the control group (group 2) after standard open vein harvesting.

Results: in the results of the observation, patients of both groups significantly differed in the number of postoperative complications on the lower extremities in the area of vein harvesting (1.14% in group 1 and 5.3% in group 2, p <0.0002). These are cases of lymphorrhea, hematomas, infections, suture divergence, which in 4.8% of cases led to secondary surgical treatment in patients after open vein harvesting. Ultimately, the length of hospital stay in patients of group 2 significantly increased to 12±3.5 days compared to patients of group 1 (8±1.3 days) (p<0.0001). In the mean time frame of 5±0.3 years, no significant difference in the incidence of the primary composite endpoint (MACCE) was noted in both groups. which was noted in 23 (13.5%) cases in the OVH group and in 25 (14.4%) cases in the EVH group (p=0.883). In patients of both groups there was no difference in the incidence of complications such as myocardial infarction (8.8% and 9.8%, p=0.519), repeated revascularizations (7.6% and 9.8%, p=0.37), cerebrovascular accidents (2.9% and 3.4%, p=0.794) and mortality (6.5%, and 7.5%, p=0.729).

Conclusion. endoscopic vein harvesting using the Karl Storz endoscopic stand, is less traumatic for the lower extremities during an observation period of more than 5 years and demonstrates an insignificant difference in the incidence of cardio-cerebral events.

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