ArticleThe Annals of thoracic surgery2012
Endoscopic venous harvesting by inexperienced operators compromises venous graft remodeling.
Article in The Annals of thoracic surgery, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Endoscopic versus open vein harvesting for coronary artery bypass: a systematic review and meta-analysis.Journal of cardiothoracic surgery · 2025Pooled it
- Lymphatic complication in open venous harvesting versus endoscopic venous harvesting: a systematic review and meta-analysis.General thoracic and cardiovascular surgery · 2025Pooled it
- Influence of Three Different Surgical Techniques on Microscopic Damage of Saphenous Vein Grafts-A Randomized Study.Medicina (Kaunas, Lithuania) · 2023Trial
- Choice of vein-harvest technique for coronary artery bypass grafting: rationale and design of the REGROUP trial.Clinical cardiology · 2014Trial
- Long-term results of coronary surgery with endoscopic vein harvesting.Turk gogus kalp damar cerrahisi dergisi · 2021Article
- The clinical application of microincision vein harvesting of the great saphenous vein in coronary artery bypass grafting.BMC cardiovascular disorders · 2020Article
- Saphenous vein grafts in contemporary coronary artery bypass graft surgery.Nature reviews. Cardiology · 2020Review
- Twenty-Five Years of No-Touch Saphenous Vein Harvesting for Coronary Artery Bypass Grafting: Structural Observations and Impact on Graft Performance.Brazilian journal of cardiovascular surgery · 2020Review
- P2X7R antagonism after subfailure overstretch injury of blood vessels reverses vasomotor dysfunction and prevents apoptosis.Purinergic signalling · 2017Article
- A comprehensive review on learning curve associated problems in endoscopic vein harvesting and the requirement for a standardised training programme.Journal of cardiothoracic surgery · 2016Review
- Subfailure Overstretch Injury Leads to Reversible Functional Impairment and Purinergic P2X7 Receptor Activation in Intact Vascular Tissue.Frontiers in bioengineering and biotechnology · 2016Article
- Endoscopic vein harvesting: technique, outcomes, concerns & controversies.Journal of thoracic disease · 2013Review
- Endoscopic vein harvesting is influenced by patient-related risk factors and may be of specific benefit in female patients.Interactive cardiovascular and thoracic surgery · 2013Article
- The use of minimally invasive videoscopic technique in large vessel and cardiac surgery. Does the potentially increased difficulty bring benefits to the patient?Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2013Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
7 authors.
Funding
Abstract
backgroundEndoscopic vein harvesting (EVH) is the standard of care for coronary artery bypass grafting (CABG) in the United States, but recent comparisons with open harvesting suggest that conduit quality and outcomes may be compromised in EVH. To test the hypothesis that problems with EVH may relate to its learning curve and conduit quality, we analyzed the quality and early function of conduits procured by technicians with varying experience in EVH.
methodsExperienced (more than 900 cases, n=55 patients) and novice (less than 100 cases, n=30 patients) technicians performed EVH during CABG. Subsequently, optical coherence tomography (OCT) was used to examine the conduits for vascular injury, with segments identified as injured being further examined for gene expression with an array of genes related to tissue injury. Conduit diameter was measured intra- and postoperatively (day 5 and 6 months, respectively) with OCT and computed tomographic angiography.
resultsEndoscopic vein harvesting by novice harvesters resulted in a greater number of discrete graft injuries and greater expression of tissue-injury genes than EVH done by experienced harvesters. Regression analysis revealed an association between shear stress and early dilation of engrafted vessels (positive remodeling) (R2=0.48, p<0.01). Injured veins showed blunted positive remodeling at 5 days after harvesting and a greater degree of late lumen loss at 6 months.
conclusionsUnder normal conditions, intraluminal shear stress leads to positive remodeling of vein grafts during the first postoperative week. Injury to conduits, a frequent sequela of the learning curve for EVH, was a predictor of early graft failure and of blunted positive remodeling and greater negative remodeling of endoscopically harvested vein grafts. Given the current annual volume of cases in which EVH is used, rigorous monitoring of the learning curve for this procedure represents an important and unrecognized issue in public health.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.