Bitter Harvest?

Disturbing long-term observational results suggest that endoscopic vein harvesting for CABG increases the risk for several adverse outcomes.

Endoscopic harvesting of veins for coronary artery bypass grafting has become popular because it reduces the risks for wound infection and postoperative pain compared with vein harvesting under direct vision (open harvesting). However, the long-term effects of endoscopic harvesting on angiographic and clinical outcomes are unknown. The Project of Ex-vivo Vein Graft Engineering via Transfection IV (PREVENT IV) trial included 3014 CABG recipients; patients' median age was 64, and almost 80% were men. Individual surgeons decided which vein harvesting method to use; 1753 patients underwent endoscopic harvesting, and 1247 underwent open harvesting.

Results of angiographic assessment 12 to 18 months after surgery were available for 1817 participan…

Reviewing Author

Harlan M. Krumholz, MD, SM

Disclosures

Consultant/Advisory BoardUnited Healthcare; Element Science; Eyedentifeye, F-Prime

EquityHugo Health; Refactor Health; Element Science

Grant/Research SupportPfizer; Agency for Healthcare Research and Quality; Janssen Research and Development, National Institute of Biomedical Imaging and Engineering; National Heart, Lung, and Blood Institute; Centers for Disease Control and Prevention; National Cancer Institute; American Heart Association

Harlan M. Krumholz, MD, SM

Disclosures

Consultant/Advisory BoardUnited Healthcare; Element Science; Eyedentifeye, F-Prime

EquityHugo Health; Refactor Health; Element Science