Learning Objective #1: Discuss the two surgical techniques for saphenous vein harvesting for coronary artery bypass surgery

Learning Objective #2: Identify the pros and cons of endoscopic versus open vein harvesting related to wound complications, pain, and graft patency

---

Background: CABG requires the harvesting of conduits to replace blocked vessels. Open vein harvesting (OVH)creates incisions that are sources of post-operative complications. Leg incisions are a source of wound complications leading to patient discomfort. Endoscopic vein harvesting (EVH)is performed through a minimally invasive technique. Atruamatic harvest of the vein is essential. Trauma and disruption of the endothelium is thought to accelerate atherosclerosis and patency rates. Preservation of the endothelium is a factor in long-term patency of saphenous vein grafts. EVH involves increased traction on the vein causing the potential for vascular trauma. EVH has many positive affects on wound complications, pain, and patient satisfaction levels. Although, vein graft patency rates of conduits harvested under EVH techniques have not been proven by a verifiable methodology. Current studies document patency rates through lack of post-operative MI and symptomatology, but lack 1-year post-op catherization data. Are the benefits of decreased wound complications and pain worth the potential risk of early graft failure following CABG? Purpose: This study determines if OVH vs. EVH technique influences one-year graft patency rates, wound complications, and pain levels. The results of this study will reveal the preferred method of vein harvesting for optimal patient outcomes. Method/Approach: Vein harvesting technique, wound complications, and pain levels will be monitored using the ASEPSIS tool, and the Wong-Baker pain scale. Wound and pain assessments are made on post-op day 3, discharge, at 2-week clinic visit, and during follow up phone calls. Vein graft patency rates will be revealed by a 1-year follow up heart catherization, but data is not available yet. Results/Outcomes: Preliminary data reveals decreased pain with the EVH technique. Seromas have been noted in the EVH group, and increased infection noted in OVH group, especially in diabetic patients. Data collection is in progress and patency rates are not yet available.