PATIENTS and METHODS
The study was approved by the Ethics and Research Board Committee of our
hospital (King Fahd Military Medical Complex, Dhahran, KSA) and informed
consent was obtained by all patients involved.
Between 2016 and 2018, 50 patients undergoing isolated, first time,
elective multivessel CABG with the use of one pedicled RA taken from the
non-dominant hand were prospectively randomized, using the envelope
randomization method, to two groups. In the first group (n=25 patients)
the RA was harvested endoscopically. In the second group (n=25 patients)
an open harvest technique was employed. Other types of conduits, such as
LIMA, right internal mammary artery and SVG (harvested also
endoscopically in all patients) were used as required.
These two groups were compared with regard to the following parameters:
Preoperative : demographics, comorbid conditions, cardiac
function.
Intraoperative : length of skin incision, length of harvested RA,
time harvest of RA, aortic clamping time, cardiopulmonary bypass time,
RA graft flow and pulsatility index.
Postoperative : clinical outcome, wound healing (haematomas, wound
discharge, infection), neuralgias (major or minor), vascular
complications, limitation of hand activity (hand function), patient
satisfaction, LV function (transthoracic ECHO) and 1-year RA patency by
means of 64 slice CT angiography.
To assess patient satisfaction a brief questionnaire was filled in by
the patients 12 months after their operation asking them to classify
their overall feeling from the RA harvest procedure in their arm (taking
into account symptoms of pain, neuralgias, numbness, tingling, or any
other symptom, hand function, cosmetic result) into one of the five
categories: poor, average, good, very good and excellent.