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OBJECTIVE: Endoscopic vessel harvest (EVH) is now the most prevalent technique used when the greater saphenous vein (GSV) is procured for use as a coronary artery bypass graft. Although vein quality has been assessed by various methods, little is know about thermal injury and endothelial damage to the vein when the latest generation cautery tools are utilized. This study aims to define GSV quaility when harvested utilizing current endoscopic technology.
METHODS: 30 prospective, non-randomized patients undergoing EVH of the GSV for bypass using the VASOVIEW HemoPro system were enrolled in this prospective, multi-center study. Histologic analysis (H&E staining and CD31) was performed on vein segments (N=41) where a side branch or the vein itself was divided with the HemoPro device. Secondarily intra-operative vessel interventions (simple suture closure of vein leaks other than typical ligation of side branches), vein harvest complications (thrombosis, thrombophlebitis, vein/graft injury, wound infection, nerve injury, bleeding, excessive hematoma/edema) and adverse events were recorded.
RESULTS: Endothelial damage measured by thermal spread was minimal (range 0-845um, mean 202.9um, SD 184.3um). 27/30 patients' veins required 0-1 interventions, one patient required 2 and one patient required 10. No complications or adverse events were observed prior to discharge or between 10(+/- 2) and 28 days post-operatively.
CONCLUSIONS: EVH of the GSV utilizing the VASOVIEW HemoPro system results in minimal thermal spread and endothelial damage, acceptable macroscopic vein quality and a low post-operative complication rate. Because lateral thermal spread beyond the device jaws is extreamly low (<1.0mm), the risk of endothelial damage to the main conduit when dividing side branches during harvest is minimized and graft quality optimized. This data supports the safety of this widely used technique.