Heparin Use Prior To Endoscopic Vein Harvest Improves Graft Patency In Off-Pump Coronary Artery Bypass Patients
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MAQUET Cardiovascular LLC announced that data presented at the annual meeting of the International Society for Minimally Invasive Cardiothoracic Surgery show that administration of a heparin bolus with doses as low as 2500U prior to endoscopic vein harvest (EVH) was associated with improved acute saphenous vein (SV) graft patency in patients undergoing off-pump coronary artery bypass (OPCAB). Pre-heparinization was also linked to a significant reduction in the incidence and volume of residual clot strands within the vein.
In EVH, a small incision is made in the leg, through which an endoscope is passed and the vein harvested for coronary artery bypass graft (CABG) procedures. This method reduces patient discomfort and scarring.
EVH also significantly reduces wound complications and hastens recovery time compared to traditional techniques that involve a long incision to expose the entire length of the vein.
"In our experience, the impact of pre-heparinization on surgical bleeding is minimal, making it a promising strategy that may improve patient outcomes with minimally invasive vein harvesting," said lead investigator Robert Poston, M.D., Chief, Division of Cardiac Surgery, Boston University.
The prospective study examined acute patency rates in 460 patients that underwent OPCAB using veins acquired through EVH, comparing patients receiving no heparin prior to harvest (n=306) to those who received one of three doses of heparin prior to the procedure (n=181). A subset of the most recent 110 patients underwent catheter-based infrared imaging (OCT) of the full tract of harvested SV in order to measure residual clot within the vein. Overall, vein graft patency was 98.9 percent in patients treated with heparin compared to 95.2 percent in the controls (p<0.05). In the subset of the most recent patients, 42 percent of patients receiving pre-heparinization showed residual clot in the harvested vein compared with 85 percent of patients that didn't receive heparin (p<0.05). Clot volume and the percentage of the vein containing clot were also significantly reduced with the use of heparin prior to EVH.
"These data are evidence that with pre-heparinization, EVH can be performed with excellent patency results in patients who require coronary artery bypass grafting, reinforcing the efficacy of this procedure," said Dr. Poston.
"We are encouraged by the results of this study and see it as a true advance in patient care," said Pat Walsh, Chief Operating Officer of the Cardiac Surgery division of MAQUET. "As a leader in EVH, MAQUET is committed to helping physicians continue to optimize EVH conduit quality and patient outcomes."
About MAQUET Cardiovascular
MAQUET Cardiovascular LLC is a division of MAQUET Medical Systems, part of the publicly listed Swedish group of companies GETINGE AB. MAQUET Cardiovascular was recently formed by combining MAQUET Cardiopulmonary with Boston Scientific's Vascular Surgery and Cardiac Surgery divisions, which includes the products and services of Guidant Cardiac Surgery and the VASOVIEW endoscopic vessel harvesting system. The creation of this new organization enables MAQUET to offer a comprehensive array of patient care solutions for less-invasive endoscopic vessel harvesting, off- and on-pump coronary artery bypass surgery and vascular grafts.
MAQUET has 170 years of healthcare experience, and is committed to becoming "The Gold Standard" for therapeutic medical equipment across the globe. As a market leader, MAQUET offers innovative medical solutions from three divisions: Surgical Workplaces, Critical Care and Cardiovascular.
Source: MAQUET Cardiovascular LLC
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