Dr. Nancy E. Reid, MHA, DHSc, PA-C, DFAAPA
Coronary artery disease (CAD) continues to be at the forefront of diseases that plague many Americans. For the thousands of patients with multi-vessel CAD, lifesaving coronary artery bypass grafting (CABG) surgery is performed to revascularize their heart, adding years to one’s life. Harvesting saphenous vein as conduit for revascularization was previously done via an open vein harvest technique (OVH) which resulted in abundant complications that effected patient outcomes. Since the mid-1990s the use of endoscopic vein harvesting (EVH) has been implemented and refined over the years. Numerous studies over the last two and a half decades have tried to answer the question of which method is superior. This has been commonly measured by adverse events/outcomes such as graft patency and mortality. Ironically, critical variables such as harvester experience were only recently included in research study designs and discussion. This variable, along with many others have never been greatly discussed, researched, or accounted for. In this article, the data regarding EVH versus OVH will be reviewed and variables within the data will be innately examined. In addition, the effects that each technique has on adverse events/outcomes will be highlighted. Review of the data shows that further research conducted should control for these often overlooked, critical variables. Before extrapolating conclusions on which technique is ultimately superior, it is paramount that one must be confident in that data and knowledgeable to evolve their research to consider methods to include the variables outlined in this review.
Murray A. Endoscopic Vein Harvest Technique Compared to Open Technique: Forgotten Variables Within the Data and the Multi-Decade Debate. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2021; 3(4).
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