Use of doppler ultrasound for saphenous vein mapping to obtain grafts for coronary artery bypass grafting
Rev. bras. cir. cardiovasc; 33 (2), 2018
Publication year: 2018
Abstract Introduction:
The great saphenous vein is widely used as a graft in coronary artery bypass grafting surgery. Complications due to saphenous vein harvesting can be minimized when using ultrasonography mapping and marking.Objective:
To analyze by clinical trial the use of vascular ultrasonography to map the saphenous vein in coronary artery bypass grafting to determine viability and dissection site.Methods:
A total of 151 consecutive patients submitted to coronary artery bypass surgery with the use of the great saphenous vein as a graft were selected for this prospective study.They were divided into two groups:
Group 1 - 84 patients were submitted to ultrasonographic mapping and marking of the saphenous vein; Group 2 - 67 patients had saphenous vein harvested without any previous study. Both groups were coupled with follow-up on the 1st, 5th and 30th postoperative days. Primary endpoints were need for incision of the contralateral leg and wound complications within 30 days.Results:
Both legs had to be incised in 6 (8.95%) patients from Group 2 (P=0.0067). Wound complications occurred in 33 (23.4%) patients within 30 days, 21 (35%) from Group 2 e 12 (14.8%) from Group 1 (OR 3.095, 1.375-6.944, CI 95%, P=0.008). Within 30 days there were 4 (2.8%) deaths, all in Group 2 (P=0.036).Conclusion:
The use of vascular ultrasonography for mapping of the great saphenous vein in coronary artery bypass surgery has properly identified and evaluated the saphenous vein, significantly reducing wound complications and unnecessary incisions. It would be advisable to use this noninvasive and easy to use method routinely in coronary artery bypass surgery.
Puente de Arteria Coronaria/métodos, Complicaciones Posoperatorias, Estudios Prospectivos, Reproducibilidad de los Resultados, Vena Safena/diagnóstico por imagen, Vena Safena/trasplante, Estadísticas no Paramétricas, Infección de la Herida Quirúrgica, Factores de Tiempo, Recolección de Tejidos y Órganos/efectos adversos, Recolección de Tejidos y Órganos/métodos, Ultrasonografía Doppler/efectos adversos, Ultrasonografía Doppler/métodos