Long-term Graft Patency of Saphenous Vein Grafts after Endoscopic Harvest in Aortocoronary Bypass Surgery

Endoscopic vein harvest of the greater saphenous vein for aortocoronary bypass grafting presents a relatively newer and less invasive mode of vein harvest that has become a more popular approach used in the field of cardiac surgery. This study aimed to compare the long-term patency of saphenous vein grafts and clinical outcomes (a minimum of 10 years) after endoscopic harvest with open vein harvest in patients after isolated surgical myocardial revascularization. Fifty patients (25 after endoscopic and 25 after open harvest) who underwent isolated myocardial revascularization between 2009 and 2011 assessed. The study comprised two phases: completion of questionnaires assessing recurring symptoms of ischemic heart disease and visualisation of vein grafts via coronary computed tomography angiography to assess graft patency. The primary outcome showed higher patency rates after open vein harvest (76.1 vs. 68.8%); without significant statistical difference (p=0.873). Differences in clinical outcomes were not statistically significant regarding recurring angina (28% endoscopic group, 32% open group, p=0.519), dyspnea (24 vs. 16%, p=0.817) and myocardial infarctions with catheter-based revascularization of vein grafts (8% endoscopic group, 16% open, p=0.734). Redo surgery was not reported in neither group. Endoscopic and open vein harvest yielded comparable long-term patency rates both angiographically and clinically. That strenghtens endoscopic approach as a non-inferior mode to the traditional approach in patients undergoing surgical myocardial revascularization.