There are three techniques for harvesting a vessel for a CABG procedure: open, bridging, and EVH. EVH uses special instruments to view and remove a blood vessel with much less trauma to the vessel itself or to surrounding tissues than bridging or an “open” procedure.
In Endoscopic Vessel Harvesting (EVH), a healthy blood vessel used in the bypass procedure is removed from the leg or arm through a single one-inch incision, compared with traditional open harvesting procedures that require longer, more-invasive incisions to access the vessel.
Since the introduction of EVH, clinicians have been able to provide 1 million CABG patients with a higher standard of care and clinical benefits.
In the past, one long incision was made from the ankle to the groin; this procedure is called an open procedure. It is highly invasive and often caused patients more pain than their chest incision, and resulted in a long scar. An alternative, less invasive technique to the open procedure is called “bridging”. Bridging enables harvesters to gain access to the saphenous vein through three or four smaller incisions of about three inches.
The EVH option is even more minimally invasive and uses special instruments to view and remove the blood vessel and usually only requires one small incision about one inch long. The EVH procedure is performed immediately before heart surgery. One or more of these vessels may be harvested:
- The greater saphenous vein, which runs the length of the leg
- The radial artery, which runs from the wrist to the elbow in the arm
- The internal mammary artery, which is in the chest
There is generally little patient discomfort from endoscopic vessel harvesting, especially when compared to open or bridging procedures. In clinical studies, some important benefits have been shown in EVH including:
- Significantly less risk of infection and wound complications
- Less postoperative pain and swelling
- Faster recovery with minimal scarring
- Greater patient satisfaction
