ABSTRACT
Following the introduction of aorto-coronary bypass grafting in 1968, the use of saphenous veins as conduits for revascularization has become an established method treatment for symptomatic coronary artery disease. The role of damaged endothelium in early graft occlusion has been extensively demonstrated. Seventy percent of early graft occlusions in coronary artery bypasses were caused by thrombi overlying areas of endothelial loss. Was to assess by morphological and histological examination the degree of vascular trauma of saphenous vein conduits harvested by an endoscopic technique compared with those harvested by conventional open methods, in order to evaluate the safety of both techniques. Saphenous vein specimens were collected from 120 patients undergoing elective Coronary artery bypass grafting [CABG] surgery and randomized into two groups: Endoscopic Saphenous Vein Harvesting [ESVH] group A and Open Saphenous Vein Harvesting [OSVH] group B. Small parts of the vein were processed for routine light and scanning electron microscopy assessment. Most of the examined sections of the saphenous vein showed mild to moderate histological disruption in the form of intimal endothelial loss and medial tears. Scanning electron microscopy showed some endothelial separation, basement membrane exposure and adherent blood cells and fibrin. These findings were more evident in group A than in group B, but the statistical analysis of the quantitative data showed that this difference was of no significant value. This study proved that ESVH adversely affects the histological structure of the vein more than OSVH, but the difference between both techniques remains statistically insignificant. This means that the OSVH still has the upper hand in preservation of vein integrity compared to ESVH and more skilful training of the surgeons to safely harvest the veins endoscopically is strongly needed