Endoscopic Conduit Harvesting: Best Practice Training Guidelines

Krishnamoorthy, Bhuvaneswari; Blackmore, Jared

Abstract

The great saphenous vein remains the most commonly used conduit for non-left anterior descending coronary artery bypass graft surgery. The aim of this chapter is to define the best practice training standards for use of the Endoscopic Vein Harvesting (EVH) technique during coronary artery bypass surgery. This chapter has been collated by an international multidisciplinary panel of advanced practice providers, surgeons, cardiologists and anaesthetists with common interests and expertise in caring for patients with coronary artery disease. These proposed training standards have been developed using current best evidence and from experiences of those most closely involved in the process, with proposals receiving approval for recommendation by consensus. A total of 11 criteria for best training practice were defined including recommendations on patient selection, surgical training, ultrasound vein scanning, heparinisation, diathermy settings, CO2 insufflation and setting, training/volume threshold, harvesting with minimal surrounding tissues, use of pressure-controlled syringe for vein distension and the need for regular audit. The team agrees that EVH is a standard practice in USA, however in the rest of the world there still remains a reticence about EVH due to concerns about the quality of the vein and cost of equipment. There are lots of differences in harvesting practices between USA and the rest of the world due to there being no documented and accepted standards of EVH best practice. The main aim of writing this chapter was to produce a resource to which all EVH trainee practitioners can refer. We hope it will provide the first set of standards and promote safe practice by surgical colleagues to ensure high quality conduits are retrieved and prevent harm to the patient during training.

• Online Publication Date: Jun 15, 2023
• Publication Date: Jun 15, 2023
• Deposit Date: Nov 28, 2024
• Publisher: Springer
• Pages: 51-67
• Book Title: Endoscopic Cardiac Surgery : Tips, Tricks and Traps
• ISBN: 9783031211041
• DOI: https://doi.org/10.1007/978-3-031-21104-1_4