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Poster: Faster recovery. Smaller scars. Less pain.

If your doctor is recommending Coronary Artery Bypass Graft (CABG) surgery, itís time to learn about Endoscopic Vessel Harvesting (EVH).

Poster: Faster recovery. Smaller scars. Less pain.

If your doctor is recommending Coronary Artery Bypass Graft (CABG) surgery, itís time to learn about Endoscopic Vessel Harvesting (EVH).

Faster recovery. Smaller scars. Less pain.

If your doctor is recommending Coronary Artery Bypass Graft (CABG) surgery, itís time to learn about Endoscopic Vessel Harvesting (EVH).

Faster recovery. Smaller scars. Less pain.

If your doctor is recommending Coronary Artery Bypass Graft (CABG) surgery, itís time to learn about Endoscopic Vessel Harvesting (EVH).

Faster recovery. Smaller scars. Less pain.

If your doctor is recommending Coronary Artery Bypass Graft (CABG) surgery, itís time to learn about Endoscopic Vessel Harvesting (EVH).

Faster recovery. Smaller scars. Less pain.

If your doctor is recommending Coronary Artery Bypass Graft (CABG) surgery, itís time to learn about Endoscopic Vessel Harvesting (EVH).

Faster recovery. Smaller scars. Less pain.

If your doctor is recommending Coronary Artery Bypass Graft (CABG) surgery, itís time to learn about Endoscopic Vessel Harvesting (EVH).

Faster recovery. Smaller scars. Less pain.

If your doctor is recommending Coronary Artery Bypass Graft (CABG) surgery, itís time to learn about Endoscopic Vessel Harvesting (EVH).

Faster recovery. Smaller scars. Less pain.

If your doctor is recommending Coronary Artery Bypass Graft (CABG) surgery, itís time to learn about Endoscopic Vessel Harvesting (EVH).

Faster recovery. Smaller scars. Less pain.

If your doctor is recommending Coronary Artery Bypass Graft (CABG) surgery, itís time to learn about Endoscopic Vessel Harvesting (EVH).

Faster recovery. Smaller scars. Less pain.

If your doctor is recommending Coronary Artery Bypass Graft (CABG) surgery, itís time to learn about Endoscopic Vessel Harvesting (EVH).

Faster recovery. Smaller scars. Less pain.

If your doctor is recommending Coronary Artery Bypass Graft (CABG) surgery, itís time to learn about Endoscopic Vessel Harvesting (EVH).

Faster recovery. Smaller scars. Less pain.

If your doctor is recommending Coronary Artery Bypass Graft (CABG) surgery, itís time to learn about Endoscopic Vessel Harvesting (EVH).

The Debate is Over. EVH is Safe, Effective and Proven.

Since 2009, five independent studies have reaffirmed that endoscopic vessel harvesting (EVH) is the proven and effective therapy for the 21st century.

Randomized trial of endoscopic versus open vein harvest for coronary artery bypass grafting: six month patency rates

Yun KL et all. Objective:†We sought to compare the 6-month angiographic patency rates of greater saphenous veins removed during coronary artery bypass grafting with the endoscopic vein harvest or open vein harvest techniques.††

Association between endoscopic versus open vein-graft harvesting and mortality, wound complications, and cardiovascular events in patients undergoing CABG Surgery

Williams JB et all. Objective:†To compare the long-term outcomes of endoscopic versus open vein-graft harvesting for Medicare patients undergoing CABG surgery in the United States.

Endoscopically assisted in situ lower extremity bypass graft: a preliminary report of a new minimally invasive technique

Suggs WD, Sanchez LA, et all. Objective:†Lower extremity arterial reconstructions with in situ greater saphenous vein (GSV) are an important component of limb salvage surgery. Initially, the procedure was performed through continuous skin incisions for side branch occlusion and valve lysis with a wound complication rate of 5% to 25%. To decrease these complications, endoscopic GSV harvest equipment was used in 25 in situ vein bypass grafts in 25 patients performed over 24 months.

The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 1ócoronary artery bypass grafting surgery

Shahian DM, OíBrien SM, et all. Background: The first version of The Society of Thoracic Surgeons National Adult Cardiac Surgery Database (STS NCD) was developed nearly 2 decades ago. Since its inception, the number of participants has grown dramatically, patient acuity has increased, and overall outcomes have consistently improved. To adjust for these and other changes, all STS risk models have undergone periodic revisions. This report provides a detailed description of the 2008 STS risk model for coronary artery bypass grafting surgery (CABG).†

Heparin administration prior to endoscopic vein harvest limits clot retention and improves graft patency

Poston R, Desai P et all. Objective:†Residual clot strands within the saphenous vein (SV) is an increasingly recognized sequela of endoscopic vein harvest (EVH). CO2 insufflation, used to facilitate visualization, causes stagnation of blood within the SV yet anticoagulation is not usually given until after harvest. We hypothesized that heparinization prior to CO2 insufflation would reduce the severity of this residual clot and improve graft patency.

A prospective randomized angiographic study of open versus endoscopic saphenectomy for CABG

Perrault LP, Bilodeau L, et all. Objective: Although endoscopic saphenectomy for coronary artery bypass grafting surgery (CABG) is associated with a decreased incidence of wound complications and has shown no increased incidence of histological trauma or endothelial dysfunction, a concern remains about the angiographic results of saphenous vein grafts (SVG) harvested with this technique in regard to the development of intimal hyperplasia in the body of the graft due to bipolar cauterisation of side branches. The purpose of this study was to compare the angiographic appearance of SVG harvested with the open versus endoscopic technique after CABG.

Endoscopic versus open vein-graft harvesting in coronary-artery bypass surgery

Lopes RD, Hafley GE, Allen KB, et all. Background: Vein-graft harvesting with the use of endoscopy (endoscopic harvesting) is a technique that is widely used to reduce postoperative wound complications after coronary-artery bypass grafting (CABG), but the long-term effects on the rate of vein-graft failure and on clinical outcomes are unknown.

A prospective randomized trial of endoscopic versus conventional harvesting of the saphenous vein in coronary artery bypass surgery

Kiaii B, Moon BC, Massel D, Langlois Y, et all. Objectives: Our objectives were (1) to determine whether minimally invasive endoscopic harvesting of the saphenous vein reduces morbidity due to postoperative wound infection and pain with improved cosmetic results and mobilization as compared with the conventional technique and (2) to compare the histologic properties of the saphenous veins harvested conventionally and endoscopically.

Prospective analysis of endoscopic vein harvesting

Patel AN, Hebeler RF, et all. Background: Utilization of bridging vein harvesting (BVH) of saphenous vein grafts (SVG) for coronary artery bypass grafting results in large wounds with great potential for pain and infection. Endoscopic vein harvesting (EVH) may significantly reduce the morbidity associated with SVG harvesting.

Endoscopic radial artery harvesting is better than the open technique

Patel AN, Henry AC, et all. Background: Radial arteries are being used more often for coronary artery bypass grafting. A minimally invasive technique was devised for harvesting vessels and compared with the traditional harvesting technique.

High-pressure distention of the saphenous vein during preparation results in increased markers of inflammation: a potential mechanism for graft failure

Khaleel MS, Dorheim TA, et all. Background: Coronary artery disease is the single leading cause of death in the United States. Commonly it is treated with coronary bypass grafting using the saphenous vein (SV) or internal mammary artery (IMA) as a conduit.† Unfortunately, the SV has much lower patency rates compared with the IMA. Several hypotheses exist as to why occlusion occurs more commonly in SV grafts than in IMA grafts. However detailed studies in this area have been limited. This study investigates the effects of pressure distention on inflammation in SV conduit used in coronary artery bypass grafting (CABG).

Impact of endoscopic versus open saphenous vein harvest techniques on outcomes after coronary artery bypass grafting

Ouzounian M, Hassan A, Buth KJ, et all. Background: Endoscopic saphenous vein harvest (EVH) decreases leg wound infections and improves cosmesis after coronary artery bypass grafting (CABG). Recent data, however, suggest that EVH may be associated with reduced graft patency rates. The objective of this study is to assess the effect of EVH on short-term and midterm outcomes after CABG.

Minimally invasive saphenous vein harvesting

Morris RJ, Butler MT et all. Background: Minimally invasive techniques to harvest the saphenous vein for coronary artery bypass grafting continue to improve and evolve. Smaller cutaneous incisions have been shown to decrease postoperative discomfort and improve healing. We describe a technique involving carbon dioxide insufflation and endoscopic dissection to allow easier and atraumatic dissection.†

Current perspectives in endoscopic vessel harvesting for coronary artery bypass grafting

Kempfert J, Rastan A, Leontyev S et all. Background: Coronary artery bypass grafting is still the most commonly performed procedure in cardiac surgery. Minimally invasive or endoscopic vessel harvesting was developed a decade ago. It has been shown that these less traumatic techniques significantly reduce wound healing† problems and improve patient satisfaction. However, there are some concerns regarding bypass patency and long-term outcomes. The aim of this article is to describe the historic development of endoscopic vessel harvesting, different harvesting techniques and to give an update of the scientific evidence and the current debate regarding outcome and safety of these minimally invasive techniques.

Histologic evidence of the safety of endoscopic saphenous vein graft preparation

Meyer DM, Rogers TE, et all. Background: Endoscopic methods of saphenous vein procurement have recently been introduced. These techniques have been successful in limiting pain and wound complications, but less information on assessing potential trauma to the harvested vein segment is available.†

Financial impact of endoscopic vein harvest for infrainguinal bypass

Illig KA, Rhodes JM et all. Objective: The purpose of this study was to determine the financial and clinical impact of endoscopic saphenous vein harvest for lower extremity bypass.†

What is the impact of endoscopic vein harvesting on clinical outcomes following coronary artery bypass graft surgery?

Grant SW, Grayson AD et all. Objective: Endoscopic vein harvesting (EVH) is increasingly used as an alternative to open vein harvesting (OVH) for coronary artery bypass graft (CABG) surgery. Concerns about the safety of EVH with regard to midterm clinical outcomes following CABG have been raised. The objective of this study was to assess the impact of EVH on short-term and midterm clinical outcomes following CABG.†

Endoscopic versus open saphenous vein harvest for femoral to below the knee arterial bypass using saphenous vein graft

Gazoni LM, Carty R, Skinner J et all. Background: Although the use of endoscopic vein harvest in coronary artery bypass grafting is accepted, few studies have documented the implementation of EVH in peripheral vascular disease surgery. Gazoni et al hypothesized that EVH improves outcomes compared with open vein harvest (OVH) in patients undergoing femoral to below the knee arterial bypass surgery.

A decade of changeórisk profiles and outcomes for isolated coronary artery bypass grafting procedures, 1990-1999: a report from the STS National Database Committee and the Duke Clinical Research Insti

Ferguson TB Jr, Hammill BG et all. Background: The Society of Thoracic Surgeons National Adult Cardiac Database is the largest voluntary clinical database in medicine. Using this database we examined changes in the risk profile of patients undergoing isolated coronary artery bypass grafting (CABG) and their outcomes during the decade 1990 to 1999.

Encouraging results with endoscopic vein harvest for infrainguinal bypass

Erdoes LS, Milner TP.† Background: Wound complications after infrainguinal vein bypass remain a significant source of morbidity. Endoscopic saphenous vein harvest has emerged as a viable alternative to minimize vein harvest incisions.

Graft patency following endoscopic saphenous vein harvesting (EVH) is equivalent to or better than traditional harvest

Davis Z, Clark S, Bufalino V et all. Objective: EVH is safe, effective, with less leg pain and morbidity than traditionally harvested saphenous veins and with no histologically evident vein damage. Long term graft patency following EVH remains unknown.

Endoscopic vein harvest for coronary artery bypass grafting: technique and outcomes

Davis Z, Jacobs HK, Zhang M et all. Background: The greater saphenous vein is a common conduit for coronary revascularizations. Traditional vein harvesting uses long incision(s) that can lead to significant morbidities. A minimally invasive technique has been developed that allows the harvest of much of the saphenous vein with one incision and fewer morbidities.

Long-term outcomes of endoscopic vein harvesting after coronary artery bypass grafting

Dacey LJ, Braxton JH Jr et all. Background: Use of endoscopic saphenous vein harvesting has developed into a routine surgical approach at many cardiothoracic surgical centers. The association between this technique and long-term morbidity and mortality has recently been called into question. The present report describes the use of open versus endoscopic vein harvesting and risk of mortality and repeat revascularization in northern New England during a time period (2001 to 2004) in which both techniques were being performed.†

Open versus endoscopic saphenous vein harvesting: wound complications and vein quality

Crouch JD, OíHair DP, Keuler JP et all. Background: The saphenous vein is an important conduit for coronary artery bypass grafting. Wound complications from traditional open vein harvesting occur often. Minimally invasive endoscopic saphenous vein harvesting may decrease wound complications. Vein quality may be an issue with endoscopic harvesting.

Traction injury during minimally invasive harvesting of the saphenous vein is associated with impaired endothelial function

Cook RC, Crowley CM et all. Objective: Many methods of minimally invasive surgical harvesting of the great saphenous vein have been developed because of the morbidity related to the long skin incision after traditional (open) great saphenous vein harvesting. One such method involves the use of multiple small incisions separated by 10- to 15-cm skin bridges through which the saphenous vein is harvested. Cook et al hypothesized that this method of saphenous vein harvesting might subject the saphenous vein to considerable traction forces, resulting in impaired endothelial cell function.

Endoscopic radial artery harvesting: results of first 300 patients

Connolly MW, Torrillo LD et all. Background: With the expanded use of the radial artery as a bypass conduit in patients undergoing coronary artery bypass grafting, an endoscopic radial artery harvesting method was used to improve esthetics and patient acceptance, and possibly, to decrease hand neurologic complications.

Clinical benefits of endoscopic vein harvesting in patients with risk factors for saphenectomy wound infections undergoing coronary artery bypass grafting

Carpino PA, Khabbaz KR et all. Objective: The influence of endoscopic harvesting techniques on the prevalence of leg-wound complications after coronary artery bypass grafting remains to be defined or patients at high risk for the development of wound infections.

Great saphenous vein harvesting: a systematic review and meta-analysis of open versus endoscopic techniques

Cadwallader RA, Walsh SR et all. Background: The great saphenous vein is frequently harvested for use as a conduit in lower limb bypass surgery. A number of papers advocate the use of an endoscopic technique rather than a traditional open technique to minimize the associated morbidity. We undertook a systematic review and meta-analysis to compare morbidity associated with these 2 techniques.

Incidence of residual clot strands in saphenous vein grafts after endoscopic harvest

Burris N, Schwartz K et all. Objective: Strands of clot are frequently flushed out of saphenous vein grafts (SVG) during preparation for grafting, particularly those that are endoscopically harvested. owever, saline distention at uncontrolled pressures increases graft thrombogenicity and the risk of early failure after coronary artery bypass grafting. The purpose of this prospective investigation was to define the incidence of intraluminal clot within endoscopically harvested SVG and the effect of attempted removal by saline distention.

Endoscopic versus direct vision for saphenous vein graft harvesting in coronary artery bypass surgery

Ad N, Henry L, Hunt S et all. Objective: Recent reports have suggested harvesting of the greater saphenous vein for coronary artery bypass (CABG) using endoscopic techniques (endoscopic) results in early graft closure, higher rates of myocardial infarction (MI) and death. We explored the impact of this technique performed by experienced operators on postoperative morbidities, MI and death in our CABG patients.

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