An Improved Technique for Long Saphenous Vein Harvesting for Coronary Revascularization

A prospective study was undertaken to assess the functional quality of long saphenous vein for coronary revascularization when it has been harvested by means of multiple small incisions and use of the Mayo "stripper." This avoids a "long cut" and the major wound problems commonly associated with it. Between January, 1979, and July, 1984, 2,439 patients underwent coronary artery bypass graft with long saphenous vein harvested by this technique. No major wound problems occurred, and minor wound problems were seen in only 23 patients (0.9%). Vein quality was assessed by histological studies of veins, postoperative graft angiography, and exercise testing. Both light electron microscopy and scanning electron microscopy demonstrated that the vein was of good quality and that the intima had been preserved. Postoperative graft angiography and exercise testing confirmed high patency rates for the vein grafts (93%). Vein harvesting with this technique is easy, gives good quality vein, both morphologically and functionally, for grafting, is associated with a minimum of wound problems, and has cosmetically superior results.