Background: Traditional open surgical vein harvesting during coronary artery bypass grafting (CABG) is associated with considerable postoperative problems including discomfort, swelling, skin discoloration, wound drainage, superficial wound infections, and scarring. Minimally invasive endoscopic vein harvesting (EVH) technique has been widely accepted by surgeons and patients worldwide. The aim of this study was to review our initial experience with EVH in patients undergoing CABG at our center.

Methods: The study included 32 patients (6 women, 26 men; mean age 62±10 years; range 41-80 years) who underwent isolated CABG between December 2005 and June 2006. A standard 2-cm incision at the medial aspect of the knee was used for EVH. The mean follow-up was 5±3 months.

Results: Two patients required conversion to open technique due to bleeding and were not included in the evaluation. Endoscopic procurement of the saphenous vein was successful in the remaining patients. The mean number of bypass grafts used was 3.6±0.5. The mean length of vein conduit was 45.0±12.6 cm, which was 38.3±5.7 cm in the first 10 patients and 50.1±13 cm in the last 10 patients. The mean length of vertical incision was 4.1±2.0 cm. The overall mean harvesting time was 43.5±9.5 min. Harvesting time gradually decreased over time (from 90 to 25 min). The average time for closing the leg skin incision was 6.6±2.9 min. A drainage catheter was necessary in only two patients. Complications related to EVH were postoperative hematoma in two patients (6.7%) and superficial ecchymosis in one (3.3%). The mean hospital stay was 6.5±0.9 days. No wound infections were seen postoperatively. No early or late deaths occurred. All the patients expressed remarkable satisfaction with regard to mobilization and early healing of leg incisions.

Conclusion: Our initial experience supports the previously shown safety and efficacy of the EVH technique compared to the traditional open technique. High-satisfaction expressed by the patients should encourage the routine use of EVH during CABG.

Keywords : Coronary artery bypass/adverse effects; endoscopy; saphenous vein/transplantation; tissue and organ harvesting.