| Journal: | Brazilian journal of cardiovascular surgery |
| Database: | PERIÓDICA |
| System number: | 000290412 |
| ISSN: | 1678-9741 |
| Authors: | Martins, Antonio S1 Andrade, Rubens R Silva, Marcos A. Moraes Oliveira, Reinaldo A Campos, Nelson L. K Mola, Ricardo de Souza, Ademar R Vidotto, Julio Padovani, Carlos |
| Institutions: | 1Universidade Estadual Paulista "Julio de Mesquita Filho", Faculdade de Medicina, Botucatu, Sao Paulo. Brasil |
| Year: | 2004 |
| Season: | Abr-Jun |
| Volumen: | 19 |
| Number: | 2 |
| Pages: | 152-156 |
| Country: | Brasil |
| Language: | Portugués |
| Document type: | Artículo |
| Approach: | Caso clínico, analítico |
| English abstract | OBJECTIVE: To comparatively analyze minimally invasive procurement of saphenous veins using Mini-Harvest® system and a technique using adapted traditional instruments. METHOD: From June 1996 to January 1999, 63 patients who were submitted to Coronary Artery Bypass Grafting Surgery had their saphenous veins resected using minimally invasive techniques. In the first 30 patients of the series, a direct visualization method employing two Langenbeck's retractors was utilized and for the 33 remaining patients the Mini-Harvest® technique was utilized. RESULTS: The mean age of the patients was 61 ± 8.75 years old. Fifty-two patients were male and 11 female. Forty-five patients were diabetics, 45 were overweight or obese, 25 were smokers and 32 presented history of myocardial infarction. The mean time to resect the saphenous vein using the Langenbeck's retractors was 34.2 ± 8.14 minutes and using the Mini-Harvest® it was 39.20 ± 9.12 minutes. The lenghts of the extracted veins were similar in both groups, varying between 10 and 30 cm. There was one case of superficial dehiscence in the Langenbeck group. With two patients in the Mini-Harvest® group and one in Langenbeck's group it was necessary to revert to the traditional method of procurement. The incidence of tran-soperative infarction was 4.5% (three patients) in Langenbeck's group and 3.1% (two patients) in the Mini-Harvest® group. CONCLUSIONS: We can conclude that the minimally invasive procurement methods of the saphenous vein by direct visualization are effective and safe, both when employing adapted traditional instruments and using purpose-made retractors. We stress, however, that the Mini-Harvest® method does not require an assistant |
| Portuguese abstract | OBJETIVO: Analisar, comparativamente, a obtenção minimamente invasiva com o uso do MINI-HARVEST® e com instrumental tradicional adaptado. MÉTODO: De junho de 1996 a janeiro de 1999, 63 pacientes submetidos à cirurgia de revascularização do miocárdio tiveram suas veias safenas retiradas segundo técnica minimamente invasiva. Nos 30 primeiros pacientes da série utilizou-se método de visão direta com auxílio de dois afastadores de Langenbeck, e nos 33 restantes utilizou-se o MINI-HARVEST®. RESULTADOS: A idade média dos pacientes era de 61 ± 8,75 anos, sendo 52 homens e 11 mulheres. Quarenta e cinco pacientes eram diabéticos, 45 apresentavam sobrepeso/obesidade, 25 eram tabagistas ativos, 32 apresentavam história pregressa de infarto do miocárdio. O tempo médio de retirada da veia safena com afastadores Langenbeck foi de 34,2 ± 8,14 minutos e com o MINI-HARVEST® de 39,20 ± 9,12 minutos. A extensão de veia retirada foi similar nos dois grupos, variando de 10 a 30 cm. Houve uma deiscência superficial no grupo com afastadores de Langenbeck. Houve necessidade de reversão para método tradicional de retirada em dois casos do grupo MINI-HARVEST® e um do grupo Langenbeck. A incidência de infarto transoperatório foi 4,5% (três) no grupo Langenbeck e 3,1%(dois) no grupo MINI-HARVEST®. CONCLUSÕES: Podemos concluir que o método de obtenção de veia safena minimamente invasivo sob visão direta é efetivo e seguro, tanto com o uso de instrumentos tradicionais adaptados para este fim, como com afastadores especialmente constituídos, ressaltando-se que o |
| Disciplines: | Medicina |
| Keyword: | Cirugía, Sistema cardiovascular, Técnicas quirúrgicas, Revascularización miocárdica, Vena safena |
| Keyword: | Medicine, Cardiovascular system, Surgery, Surgical techniques, Myocardial revascularization, Saphenous vein |
| Full text: | Texto completo (Ver HTML) |
