الفهرس | Only 14 pages are availabe for public view |
Abstract Background: The choice of the graft conduit for coronary artery bypass grafting (CABG) has significant implications both in the short- and long- term. The patency of a coronary conduit is closely associated with an uneventful postoperative course, better long-term patient survival and superior freedom from re-intervention. For this reason, we had to assess the intra-operative flow of the LSV grafts harvested with the two methods conventionally and endoscopically by using Transit Time Flow meter. Methods: 60 patients with multi-vessel CAD and candidate for isolated elective CABG were included in the study, and divided into two groups. GroupI : 30 patients with LSV harvested conventionally :open vein harvesting (OVH). group II : 30 patients with LSV harvested endoscopically (EVH). The primary end point was the measurement of the intraperative flow, Pulsatility Index (PI), and acoustic coupling index(ACI%) in the LSV grafts on the left coronary system using the Transit Time Flow meter. The secondary end points included postoperative leg wound infection, pain, hematoma, and patients’ satisfaction. Results: Total of 60 patients (46 males and 14 females) with a mean age 61.07 ±8.3 in group I and 59.53 ±7.7 in group II. Both groups showed a comparable Pulsatility index and ACI % and were not significantly different. While the mean flow (ml/min) was significantly higher in EVH as compared to OVH group with (p value= 0.300, 0.791, 0.045) respectively. While for the postoperative leg wound Pain and hematoma were significantly higher in OVH group as compared to EVH group with p value=<0.001, 0.002 respectively. On the other hand Patient’s satisfaction was significantly higher in EVH group as compared to OVH group with p value=<0.001 Though the leg wound infection seemed to be higher in OVH than EVH, yet p value did not reach significance level.(p value= 0.052). Conclusion: EVH group was associated with a higher in the intraoperative mean flow (ml/min) with less postoperative leg wound pain , hematoma and infection and higher patients’ satisfaction when compared to OVH group. |