How Does the Doctor Get the Healthy Vessel?
In the past, removing the greater saphenous vein meant that one long incision was made from the ankle to the groin. This procedure often caused patients more pain than their chest incisions. There was also a significant risk of infection, not to mention a scar made patients feel self-conscious long after they recovered.
Bridging allowed the removal of the greater saphenous vein through several smaller incisions, each about 3 inches long. Like the open technique above, this has complication risks such as infection, pain, and swelling. This procedure puts a lot of tension on the vein, and recent data suggests that a bridged vessel may not perform well.
Endoscopic Vessel Harvesting (EVH)
Today, there is another option that requires only a small incision, about 2 cm (0.78 inches) long. Endoscopic vessel harvesting, known as EVH, can be used to remove the saphenous vein from the leg or the radial artery from the arm.
EVH uses special instruments to view and remove a blood vessel through a small incision. EVH not only causes much less pain and scarring, it also means that patients can recover more quickly, return to normal mobility, and begin their cardiac rehabilitation program sooner.
In several clinical studies, important benefits have been shown as a result of using endoscopic vessel harvesting, including:
- Significantly less risk of infection and wound complications
- Less postoperative pain and swelling
- Faster recovery with minimal scarring
- Greater patient satisfaction
EVH is the standard of care in the United States and is performed in most heart surgery hospitals. It is a good option for many patients. However, since each person is unique, you should discuss your choices with your doctor.