Endoscopic vein harvesting (EVH) is a procedure that takes a vein from your leg to use as part of a coronary artery bypass graft (CABG).
Why you would have EVH
If you need a CABG, it means that you need your blood flow to be increased in a narrowed or blocked coronary artery. This procedure takes a healthy artery from your leg, chest or arm and attaches it to the blocked coronary artery.
Traditionally, when a vein from the leg (saphenous vein) is taken for a CABG procedure, it is taken by making a long cut from the ankle to groin. This can leave a visible scar on your leg.
With endoscopic vein harvesting, we make smaller cuts and use minimally invasive equipment to take out the healthy blood vessel. This means that we can limit how much damage there is to the surrounding tissue.
We make a small cut just above the knee and insert an endoscope, which is a long, thin flexible tube with a camera. An image is then projected onto a screen so your doctor can locate and remove the vein. We may also make two more small cuts near the groin and/or ankle to help remove the vein.
Why EVH is better
EVH means that you will have less scarring from the vein removal compared to the more traditional method. Studies have also shown that EVH reduces the risk of infection or wound problems. This causes less pain and swelling after the procedure, which reduces the total hospital stay. This then means you would be able to start your cardiac rehabilitation programme sooner.
The term 'heart problems' incorporate a number of specific conditions, such as coronary artery disease, angina and heart attacks.
Coronary artery disease is also known as 'ischaemic heart disease' and occurs when a fatty substance called 'atheroma' develops on the inside of an artery.
We started using this technique at Harefield Hospital in 2007 and at Royal Brompton Hospital in 2009. Not all patients undergoing a CABG will not have EVH done as part of the procedure. This is a specialised service, and not all patients will be suitable for EVH. If you have any problems, questions or concerns, talk to your consultant.
Between January 2007 and December 2014, we performed 3,657 CABGs using EVH. Leg wound infection rates for EVH was only 0.2% (nine out of 3,657) compared to 2.3% for traditionally leg harvesting methods (96 out of 4,129).
Contact our cardiac physiologists
Royal Brompton Hospital
Tel: 020 7351 8641
Tel: 01895 828 566