Thorac cardiovasc Surg
DOI: 10.1055/s-0039-1683901
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Patient Satisfaction and Clinical Complications after Endoscopic or Surgical Saphenous Vein Harvesting

Tomas Filip
1  Department of Cardiovascular Surgery, Heart Centre Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Germany
,
Filip Schröther
1  Department of Cardiovascular Surgery, Heart Centre Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Germany
,
Robert Haase
1  Department of Cardiovascular Surgery, Heart Centre Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Germany
,
Nicol Rudolph
1  Department of Cardiovascular Surgery, Heart Centre Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Germany
,
Thomas Claus
1  Department of Cardiovascular Surgery, Heart Centre Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Germany
,
Johannes M. Albes
1  Department of Cardiovascular Surgery, Heart Centre Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Germany
› Author Affiliations
Further Information

Publication History

30 August 2018

12 February 2019

Publication Date:
04 April 2019 (online)

Abstract

Background Endoscopic saphenous vein harvesting (EVH) for coronary artery bypass grafting (CABG) has been developed to reduce leg wound problems. This study was undertaken to evaluate postoperative complications and patient's subjective satisfaction comparing EVH and surgical vein harvesting (SVH).

Methods From January to December 2017, patients undergoing elective cardiac surgery (CABG, CABG + Valve repair or replacement) underwent saphenous vein graft harvesting either by EVH (n = 136) or SVH (n = 104). Clinical follow-up was scheduled for day 7 and > 45 days after surgery. Primary end points were divided into two subgroups. The first one included postoperative extent of subjective pain and satisfaction with the cosmetic results described by the patients themselves, while the second subgroup included objective postoperative complications including wound healing disturbances, hematoma, and neuropathy. Secondary end point was length of hospital stay.

Results At 7 days follow-up, EVH patients were more satisfied with the cosmetic results than those of the SVH group (p < 0.001) and expressed a significant tendency toward lower subjective pain compared with the SVH patients (p < 0.001), exhibited significantly lower cellulitis (p-0.002), neuropathy (p-0.005), and superficial wound healing disturbance (p-0.007). During further follow-up at > 45 days, patients with EVH were still more satisfied with the cosmetic results (p < 0.001) and expressed lower subjective pain (p < 0.001), while the other objective wound parameters did not show significant differences between both groups. Mean length of hospital stay of EVH patients was 0.7 days less compared with SVH patients.

Conclusions Our findings demonstrate the noninferiority of EVH in the short term and in the early medium term.

Note

Parts of the data were presented at the DGTHG annual meeting in Leipzig in 2018.