Functional and Morphologic Assessment of Saphenous Veins Harvested with Minimally Invasive Techniques Using a Modified Laryngoscope

(#2000-04157 ... March 4, 2000)

Alex M. Fabricius, MD, Anno Diegeler, MD, PhD, Witek Gerber, MD, Friedrich W. Mohr, MD, PhD

Abteilung fur Herzchirurgie, Herzzentrum University of Leipzig, Leipzig, Germany

ABSTRACT

Background: Minimally invasive saphenous vein harvesting techniques have been shown to reduce postoperative morbidity. Commercially available and often disposable instruments add significant costs to the operation. To lower expenses and to reduce postoperative morbidity, we used an ordinary laryngoscope fitted with a modified #3 Heine™ blade for harvesting the greater saphenous vein for coronary artery bypass surgery.

Objective: To assess the integrity and function of the autologous, undistended, long saphenous vein harvested by a modified laryngoscope.

Methods: Morphology was examined by light and scanning electron microscopy. Endothelial function was assessed by vascular reactivity in an isolated organ bath. Veins, randomly taken and prepared traditionally, served as a control group. Contractile function was measured in response to potassium chloride. Endothelium-dependent relaxation was assessed by use of acetylcholine and calculated as percentage relaxation.

Results: There were no significant differences, in response to the constricting or dilating agent, in vein rings taken with the modified laryngoscope compared with the traditional 'open' technique (n = 10, p > 0.05 by ANOVA). Histologic examination by light and scanning electron microscopy showed no significant damage to the endothelial layer.

Conclusion: Minimally invasive saphenous vein harvesting, using a modified laryngoscope yields morphologically and biologically intact veins.

AUTHOR/ARTICLE INFORMATION

Reprint requests to: Dr Fabricius, Abteilung fur Herzchirurgie, Herzzentrum Leipzig, Russenstrasse 19, D-04289 Leipzig, Germany, Phone: 0049-341-865-1421, Fax: 0049-341-865-1452, Email: faba@server3.medizin.uni-leipzig.de

Submitted March 3, 2000; accepted March 4, 2000