Pedicled Vein Grafts in Coronary Surgery: Perioperative Data From a Randomized Trial.
Ann Thorac Surg
; 104(4): 1313-1317, 2017 Oct.
Article
em En
| MEDLINE
| ID: mdl-28648540
ABSTRACT
BACKGROUND:
Less-than-optimal long-term patency of the saphenous vein is one of the main obstacles for the success of coronary artery bypass grafting (CABG). Results from the IMPROVE-CABG trial has shown that harvesting the saphenous vein with a pedicle of perivascular tissue less than 5 mm while using manual distention provides comparable occlusion rates but significantly less intimal hyperplasia at early follow-up. The impact of pedicled veins on duration of operations, leg wound infections, and postoperative bleeding is unknown.METHODS:
One hundred patients undergoing first-time elective CABG were randomly assigned to conventional or pedicled vein harvesting. Perioperative and postoperative data were collected prospectively during the hospital stay and at follow-up.RESULTS:
Duration of extracorporeal circulation was significantly longer in the pedicled vein group (mean 76 min versus 65 min, p = 0.006); however, no significant difference was found in the cross-clamp time. No significant difference was found in intraoperative vein graft flow, postoperative bleeding, or leg wound infections (4% in each group). No reoperations were due to vein graft bleeding.CONCLUSIONS:
Harvesting a pedicled vein provides comparable postoperative bleeding and leg wound infection rates in selected patients. The technique is associated with a slightly longer duration of extracorporeal circulation than harvesting conventional veins. Promising early results using the pedicled vein technique may contribute to a change in standard vein harvesting technique for CABG in selected patients.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Veia Safena
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Ponte de Artéria Coronária
Tipo de estudo:
Clinical_trials
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Etiology_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article