Does the Method of Vein-Graft Harvesting Influence Outcomes?

In a randomized study, endoscopic vein harvesting by expert surgeons was associated with similar rates of major adverse events as open harvesting and better healing at the harvest site.

Endoscopic vein-graft harvesting is commonly used for coronary artery bypass grafting (CABG). Although it reduces complications in leg-wound healing, adverse effects on graft patency and mortality have been reported in small studies. This large, multicenter Veterans Affairs trial was designed to compare endoscopic and open harvesting (NCT01850082). Only expert endoscopic vein-graft harvesters were invited to participate, and 1150 patients undergoing on-pump CABG were randomized to open or endoscopic harvesting.

After a median follow-up of 2.8 years, the primary composite outcome of major adverse events (all-cause mortality, nonfatal myocardial infarction, or repeat revascularization) occurred in 15.5% of patients in the open-harvest group an…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)