eComment: Endoscopic harvesting results in high quality vein and arterial grafts

We have read this article with interest [1]. Endoscopic graft harvesting has been an important technical improvement in coronary bypass surgery (CABG) during the recent years. The stigma of long skin incisions has overcome and associated wound healing difficulties have decreased, with subsequent improvement in early physical ability and shortened hospital stay [2, 3]. The study by Lopes and colleagues [4] is provocative and challenges this ‘improvement’ in CABG as graft-patency might be reduced. However, there are important limitations of the study as non-randomization and detailed operative data (coronary status, target vessels bypassed, endoscopic technique and devices used) are lacking. Patency rate might depend more on patient characteristics and target variables than the vein harvesting technique used. Nevertheless, the discussion on the safety of endoscopic vein harvesting reminds us of the importance of excellent graft harvesting in CABG. While it is common use to assign graft harvesting to a non-physician practitioner or a perfusionist, the more complex endoscopic graft harvesting as such an endeavor might require more experienced technical skills. We strongly believe that endoscopic graft harvesting results in high quality vein and arterial grafts if harvested correctly.

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