Friday, July 21, 2006

New Aid for Coronary Bypass Graft Surgery

The number of people suffering from coronary artery disease in Hong Kongis rising because of the increasing prevalence of diabetes mellitus, obesity and hypertension. Coronary artery bypass surgery (CABG) isone remedy. It involves collecting the Great Saphenous Vein (OVH) ina patients leg for conduit grafting. However, the traditional open technique in obtaining this vein may cause complication in leg wounds and Chinese people prone to diabetes mellitus (around 40%) have a higher wound infection rate.

A study on the effectiveness of the Endoscopic Vein Harvest technique (EVH) for Chinese CABG patients carried out by a research team from Department of Surgery, HKU LKSFaculty of Medicine, shows that EVH is an effective technique to obtaining the Great Saphenous Vein for CABG surgery with significantly fewer wound complications.

EVH requires special instruments to perform only 3 to 4 small skin incisions of about 2cm long each. The dissection of the GreatSaphenous Vein is done inside the subcutaneous tunnel with thehelp of direct videoscopic imaging. Between March 2005 and Jan 2006, 74 patients who underwent CABG surgery performed at the GranthamHospital were chosen at random for EVH and OVH groups. Patients with severe obesity, bilateral leg varicose veins and history of deep vein thrombosis were excluded. Satisfactory analyses were carriedout on leg wound complications, post-operative pain and clinical outcomes.

EVH can be introduced to all suitable CABG patients at the Grantham Hospital in future and may also be applied to harvest theradial artery in the arm for CABG surgery