Learning Curve for Using Endoscopic Saphenous Vein Harvesting in Coronary Artery Bypass Grafting
[Objective]To investigate the application of endoscopy in obtaining the great saphenous vein(GSV)dur-ing coronary artery bypass grafting(CABG)and explore the learning curve,with a particular focus on common challenges encountered during the learning process and their impact on early clinical outcomes.[Methods]A retrospective analysis was conducted on clinical data from 83 patients who underwent off-pump CABG with endoscopic GSV harvesting at the First Affiliated Hospital of Zhengzhou University from July 2013 to April 2014.Patients were categorized into four groups based on the chronological order of their hospitalization:Group A(novice group,n=20),Group B(proficient group,n= 20),Group C(progressive group,n=20),and Group D(mature group,n=23).Differences in perioperative and midterm follow-up outcomes among the groups were analyzed to determine the learning curve period.[Results]The study popula-tion had a mean age of(60.22±8.06)years and a mean body weight of(69.77±11.66)kg.Comorbidities included hyperten-sion(24 cases),diabetes(26 cases),and subacute cerebral infarction(14 cases).The novice group exhibited significant-ly shorter GSV length-to-harvest time ratio relative to the other three groups(P<0.001)and a significantly higher inci-dence of main vein damage(P=0.006).However,there was no statistically significant difference in graft patency at the 1-year follow-up.[Conclusion]Thorough and reliable technical training in endoscopic GSV harvesting is essential to mini-mize vascular injury caused by novice operators.Approximately 20 cases of hands-on experience and a careful self-analy-sis of procedural challenges are likely required to achieve proficiency in GSV harvesting.
万方数据
维普
