Key result
Minimally invasive saphenous vein harvesting cuts wound infections ~76% vs. open harvesting.
Why the study?
The morbidity associated with long saphenous vein harvesting using traditional open technique versus a minimally invasive technique was unclear.
Does minimally invasive long saphenous vein harvesting using the Mayo vein stripper reduce morbidity compared to the traditional open technique in patients undergoing first-time CABG?
RCT (n=77)
Open-label
Minimization using a computer program
No
Does minimally invasive long saphenous vein harvesting using the Mayo vein stripper reduce morbidity compared to the traditional open technique in patients undergoing first-time CABG?
Absolute Event Rate: 5.1% vs 21.1%
p-value: p=<0.001
Minimally invasive saphenous vein harvesting using the Mayo vein stripper reduces infection rates without compromising endothelial function compared to the traditional open technique.
Supports minimally invasive saphenous vein harvesting in CABG to cut infections; extends RCT evidence for Mayo stripper with preserved endothelial function.
OBJECTIVES: The objective of this study was to compare the morbidity associated with long saphenous vein harvesting using the traditional open technique (A) against a minimally invasive technique using the Mayo vein stripper (B) that involves multiple short incisions. DESIGN: We conducted a prospective randomized controlled study in 80 patients undergoing first time coronary artery bypass grafting. Pain and healing was assessed on each postoperative day. Rings of long saphenous vein were subjected to organ-bath evaluation of endothelium-dependent and endothelium-independent relaxation. RESULTS: Three patients were excluded from the study, leaving 38 patients in Group A and 39 in Group B. With respect to operative procedure, Group A had a greater length of vein harvested than Group B. There was no statistical difference in pain scores and endothelium-dependent or endothelium-independent relaxation between the two groups. However there were significantly more infections in Group A compared with Group B. CONCLUSION: Harvesting vein through multiple incisions using the Mayo vein stripper is quicker, results in fewer infections and has no deleterious effect on endothelial function compared to open technique.
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Mahmood et al. (2006) conducted an RCT in Coronary artery disease requiring CABG (n=77). Minimally invasive vein harvesting using Mayo vein stripper vs. Traditional open vein harvesting was evaluated on Minor wound infection or worse (ASEPSIS score) (p=<0.001). Minimally invasive saphenous vein harvesting using a Mayo vein stripper significantly reduced the incidence of minor or worse wound infections compared to the traditional open technique (p<0.001).
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