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J Thorac Cardiovasc Surg 2007;134:1265
© 2007 The American Association for Thoracic Surgery

Evolving Technology

Discussion

The first 20% of the full text of this article appears below.

Dr Michael Mack (Dallas, Tex). A paper presented at the Southern Thoracic Surgical Association meeting last year analyzed the PREVENT IV trial for graft patency and found that endoscopic vein harvest was a risk factor for lower graft patency. I think there is some evidence that this may have some clinical impact, and you may have defined the mechanism.

It is always said to be dangerous to go home after a medical meeting because people change their practices based on what they heard at the meeting. On the basis of your presentation, I think I would seriously consider earlier heparinization in patients. Have you seen any adverse clinical sequelae from earlier heparinization, such as late complications or hematoma of the harvest tunnel?

Dr Brown. We have not seen any complications such as those. Increased bleeding is an obvious concern with preheparinization and seems to be one of the reasons that people are reluctant to use it. However, we found no effect of preheparinization on intraoperative blood . . . [Full Text of this Article]


Related Article

Strategies to reduce intraluminal clot formation in endoscopically harvested saphenous veins
Emile N. Brown, Zachary N. Kon, Richard Tran, Nicholas S. Burris, Junyen Gu, Patrick Laird, Philip S. Brazio, Seeta Kallam, Kimberly Schwartz, Lisa Bechtel, Ashish Joshi, Shaosong Zhang, and Robert S. Poston
J. Thorac. Cardiovasc. Surg. 2007 134: 1259-1265. [Abstract] [Full Text] [PDF]





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