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| Name | How to harvest and handle the Saphenous Vein Graft. Tips and tricks #saphenousveingraft |
| Video Uploader | Video From SBK (SBK) |
| Upload Date | This Video Uploaded At 09-04-2020 11:42:16 |
| Video Discription | #saphenousveinconduit #graftpatency #saphenousvein Saphenous vein grafts (SVGs), used during coronary artery bypass graft surgery for severe coronary artery disease, are prone to degeneration and occlusion, leading to poor long-term patency compared with arterial grafts. The rising use of arterial grafts over SVG is related to the morphologic benefit of arterial grafts as they accommodate to their role as coronary bypass grafts. While postoperatively, both the arterial and venous grafts are prone to progressive intimal hyperplasia and subsequent atherosclerosis, thrombosis, and failure, but the improved patency of arterial grafts suggests that this progressive intimal hyperplasia is not as prevalent in arterial conduits. After harvest: • Insufflate the vein with heparinised blood solution (no consensus on this). Blood acts to neutralise the pH. • Asses SVG for any points of extravasation that can be addressed with clips, ties or by oversewing with monofilament suture. • Localised varicositiesof the vein wall that can excluded from the vein wall with clips placed parallel to the vein wall. • Avulsions that may bleed later, fixed with 7-0 prolene • Adventitial constriction or narrowing of the vein generate eddy currents and may lead to early graft failure • Long branch stump may also lead to local thrombus formation and later distal embolization. Therefore the stump should be flush with the vein, not more or less. • Avoid overdistention of the vein. It may lead to intimal fractures and early graft failure. • This specimen is then placed in a heparinized warm blood saline bath until used for implantation. Patency Rates: • One 1 year after CABG, 10% to 20% of SVG fail. • 1-5 years, an additional 5% to 10% fail. • From 6 to 10 years, an additional 20% to 25% fail. • At 10 years, only about half of SVG’s are patent, and of those, only half are free of angiographic arteriosclerosis. References: 1. Sabik III JF. Understanding Saphenous Vein Graft Patency. Circulation. 2011;124:273–275 2. Peter Altshuler; Nick J. Welle. Saphenous Vein Grafts. Bookshelf ID: NBK537035PMID: 30725720. Copyright © 2020, Stat Pearls Publishing LLC. My Credentials: Facebook : https://www.facebook.com/The-Heart-Su... Youtube : https://www.youtube.com/channel/UCAXv... Gmail: sureshbkale@gmail.com Twitter: @theheartsurgeon |
| Category | Education |
| Tags | suresh babu kale | sbk | venous graft | tanjore cardiac surgeon | meenakshi hospital tanjore | saphenousv vein graft | saphenous vein patency | saphenous vein conduit | the heart factory | the heart surgeon | dr suresh babu kale | tanjore heart surgeon | cardiothoracic surgery | surgical training | graft patency | vein harvest technique | medical training | cardio thoracic surgery | health education | CABG | Bypass operation | bypass conduits |
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