2012, Number 2
<< Back Next >>
Cir Gen 2012; 34 (2)
Complications of saphenectomy in patients subjected to myocardial revascularization surgery
Payró HLE, Carmona JGA, Careaga RG, Zaldívar CJA
Language: Spanish
References: 19
Page: 125-129
PDF size: 63.81 Kb.
ABSTRACT
Objective: To know the prevalence and risk factors for complications of saphenous vein harvesting for myocardial revascularization in patients operated at the Department of Cardiothoracic Surgery.
Design: Prospective, cross-sectional, descriptive, and comparative study.
Statistical analysis: Central tendency measures and Student’s t test.
Patients and methods: We studied patients subjected to myocardial revascularization between January 1st and October 31st 2011, in whom the saphenous vein was harvested to be used as free graft, with or without using additionally the left internal mamary artery. The graft was obtained through multiple incisions. Hematoma, infection, edema, suture material rejection, dehiscence, necrosis, cellulitis, dermatitis, thrombosis, seroma, compartmental syndrome were considered complications. We compared the number of incisions, length of incisions, inverse saphenous vein obtainment, surgical time and aorta clamping between complicated and non-complicated patients.
Results: In the studied period, 150 patients (129 men and 21 women) were subjected to saphenous vein harvesting to be used as a free graft. Average age was of 61 ± 9.48 years. Prevalence of complications was of 29%, corresponding 19% (n = 29) to hematoma, 4.6% (n = 7) to infection of the surgical site, 2% (n = 3) to edema, 1.3% (n = 2) to reaction of the suture material, and 2% (n = 3) to dehiscence. No statistical difference was found in the variables between complicated and non-complicated patients.
Conclusions: Prevalence of complications in saphenous vein harvesting for myocardial revascularization was low, and was within the ranges accepted in the medical literature. We did not identify risk factors.
REFERENCES
Belczak CE, Tyszka AL, Godoy JM, Ramos RN, Belczak SQ, Caffaro RA. Clinical complications of limb undergone harvesting of great saphenous vein for coronary artery bypass grafting using bridge technique. Rev Bras Cir Cardiovasc 2009; 24: 68-72.
Luckraz H, Lowe J, Pugh N, Azzu AA. Pre-operative long saphenous vein mapping predicts vein anatomy and quality leading to improved post-operative leg morbidity. Interact Cardiovasc Thorac Surg 2008; 7: 188-191.
Markar SR, Kutty R, Edmonds L, Sadat U, Nair S. A meta-analysis of minimally invasive versus traditional open vein harvest technique for coronary artery bypass graft surgery. Interact Cardiovasc Thorac Surg 2010; 10: 266-270.
Hijazi EM. Comparative study of traditional long incision vein harvesting and multiple incisions with small skin bridges in patients with coronary artery bypass grafting at King Abdullah University Hospital-Jordan. Rev Bras Cir Cardiovasc 2010; 25: 197-201.
Yun KL, Wu Y, Aharonian V, Mansukhani P, Pfeffer TA, Sintek CF, et al. Randomized trial of endoscopic versus open vein harvest for coronary artery bypass grafting: six-month patency rates. J Thorac Cardiovasc Surg 2005; 129: 496-503.
Mahmood Z, Al Benna S, Nkere U, Murday A. Decreased morbidity following long saphenous vein harvesting using a minimally invasive technique: a randomized controlled trial comparing two techniques for long saphenous vein harvest. J Cardiothorac Surg 2006; 1: 15.
Almdahl SM, Veel T, Halvorsen P, Vold MB, Mølstad P. Randomized prospective trial of saphenous vein harvest site infection after wound closure with and without topical application of autologous platelet-rich plasma. Eur J Cardiothorac Surg 2011; 39: 44-48.
Careaga G, Guzmán R. Infección de herida quirúrgica en cirugía cardiotorácica. En: Careaga G. Manual de procedimientos básicos en cirugía cardiotorácica. México, D.F. 2005. Ed. El Manual Moderno, pag. 77-84.
Secretaría de Salud. Norma Oficial Mexicana de Emergencia NOM-EM-002-SSA2-2003, para la vigilancia epidemiológica, prevención y control de las infecciones nosocomiales. Diario Oficial de la Federación México, D.F., a 26 de noviembre de 2003.
Reed JF 3rd. Leg wound infections following greater saphenous vein harvesting: minimally invasive vein harvesting versus conventional vein harvesting. Int J Low Extrem Wounds 2008; 7: 210-219.
Paletta CE, Huang DB, Fiore AC, Swartz MT, Rilloraza FL, Gardner JE. Major leg wound complications after saphenous vein harvest for coronary revascularization. Ann Thorac Surg 2000; 70: 492-497.
Aziz O, Athanasiou T, Darzi A. Minimally invasive conduit harvesting: a systematic review. Eur J Cardiothorac Surg 2006; 29: 324-333.
Fowler VG Jr, O’Brien SM, Muhlbaier LH, Corey GR, Ferguson TB, Peterson ED. Clinical predictors of major infections after cardiac surgery. Circulation 2005; 112: I358-I365.
Mullen JC, Bentley MJ, Mong K, Karmy-Jones R, Lemermeyer G, Gelfand ET, et al. Reduction of leg wound infections following coronary artery bypass surgery. Can J Cardiol 1999; 15: 65-68.
Kayacioglu I, Camur G, Gunay R, Ates M, Sensoz Y, Alkan P, et al. The risk factors affecting the complications of saphenous vein graft harvesting in aortocoronary bypass surgery. Tohoku J Exp Med 2007; 211: 331-337.
Athanasiou T, Aziz O, Al-Ruzzeh S, Philippidis P, Jones C, Purkayastha S, et al. Are wound healing disturbances and length of hospital stay reduced with minimally invasive vein harvest? A meta-analysis. Eur J Cardiothorac Surg 2004; 26: 1015-1026.
Abbaszadeh M, Arabnia MK, Rabbani A, Mandegar MH, Vahedi S. The risk factors affecting the complications of saphenous vein graft harvesting in aortocoronary bypass surgery. Rev Bras Cir Cardiovasc 2008; 23: 317-322.
Ikram MU, Li WW, Segers P, Kloek JJ, De Mol BA. Endoscopic vein-graft harvesting for coronary bypass grafting: good results in patients at risk for surgical site infection. Ned Tijdschr Geneeskd 2010; 154: A1806.
Cadwallader RA, Walsh SR, Cooper DG, Tang TY, Sadat U, Boyle JR. Great saphenous vein harvesting: a systematic review and meta-analysis of open versus endoscopic techniques. Vasc Endovascular Surg 2009; 43: 561-566.