With more than 800,000 coronary artery bypass grafting (CABG) operations annually worldwide and the saphenous vein being the most common conduit used, there is no question that improving saphenous vein graft patency is one of the most important tasks in CABG. This video describes the no-touch harvesting procedure of the saphenous vein on an 80-year old man with hypertension, hyperlipidemia and a previous myocardial infarction with percutaneous coronary intervention to the right coronary artery. He was complaining of exertional chest pain and was diagnosed with stable angina pectoris. The coronary angiography showed advanced three vessel disease with significant stenoses in the left anterior descending (LAD) artery, two marginal arteries (MAs) and the posterior descending artery (PDA), in addition to an occluded diagonal artery (DA). The patient received a triple sequential no-touch vein graft to the PDA and two MAs together with a double sequential no-touch vein graft to the DA and LAD. A vein graft was used to bypass the LAD due to the age of the patient and the low degree of stenosis in the LAD. The no-touch harvesting technique is described in detail in the film with complete narration. A follow-up of this patient was performed at three months both clinically and with a computed tomography angiography (CTA). No angina pectoris symptoms were reported by the patient and the wounds in the chest and lower limb were completely healed. The CTA showed patent no-touch saphenous vein grafts to all the distal anastomoses.

译文

:全球每年有超过800,000例冠状动脉旁路移植术(CABG)进行操作,并且隐静脉是最常用的导管,毫无疑问,提高隐静脉移植的通畅性是CABG中最重要的任务之一。该视频介绍了一位80岁高血压,高血脂和先前有心肌梗塞的大隐静脉的非接触式采集过程,该患者经右冠状动脉经皮冠状动脉介入治疗。他抱怨劳累性胸痛,被诊断出稳定的心绞痛。冠状动脉造影显示,除了闭塞的对角动脉(DA)外,左前降支(LAD)动脉,两个边缘动脉(MAs)和后降支动脉(PDA)均伴有明显狭窄的晚期三血管疾病。该患者接受了PDA和两个MA的三连贯非接触式静脉移植,同时还接受了DA和LAD的双连贯非接触式静脉移植。由于患者年龄大和LAD狭窄程度低,因此使用静脉移植物绕过LAD。电影中以完整的叙述详细描述了非接触式收割技术。在临床和计算机断层扫描血管造影(CTA)的三个月中对该患者进行了随访。患者未报告心绞痛症状,胸部和下肢的伤口已完全治愈。 CTA显示所有远端吻合口均采用无接触隐性大隐静脉移植。

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