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OBJECTIVE: Endoscopic saphenous vein harvesting (EVH) has superior cosmetic results and fewer wound complications than conventional open harvesting (OVH), and has been reported to have satisfactory early clinical outcomes. However, mid-term outcomes after EVH remain controversial. This retrospective study, we analyzed the early and mid-term outcomes of EVH compared with OVH in patients with off-pump coronary artery bypass grafting.
METHODS:Isolated off-pump coronary artery bypass grafting using a saphenous vein graft was performed in 287 patients at our hospital between September 2009 and June 2014. Eighty-eight patients (31%) underwent EVH and 199 patients (69%) underwent OVH. Operative mortality, morbidity, early patency, wound complications, and 5-yr survival were compared in the two groups. Early patency rates were assessed using angiography or computed tomography in 192 patients (367 anastomoses).
RESULTS: The baseline characteristics of patients who underwent EVH or OVH were similar. The success rate of EVH was 100%. Operative mortality was 2.3% in the EVH group and 3.5% in the OVH group (p=0.43). The early patency of the vein graft was 90.5% in the EVH group and 90.4% in the OVH group (p=0.46). EVH was associated with a lower incidence of harvest site wound complications relative to OVH (1.1% vs. 7.0%, p=0.028). Five-year survival was 62.9±18.3% in the EVH group and 71.4±9.4% in the OVH group (p=0.59). Five-year survival free from major adverse cerebro-cardiovascular events was 44±17% in the EVH group and 44.2±8.7% in the OVH group (p=0.59).
CONCLUSIONS: EVH decreased wound complications and had marked cosmetic advantages in patients undergoing off-pump coronary artery bypass grafting. The early and mid-term clinical outcomes of EVH were equivalent to those of OVH.