"You say you want a revolution ..."

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Kaitlyn Dmyterko, staff writer

“You say you got a real solution. Well, you know we'd all love to see the plan,” the Beatles sang in their 1968 hit, Revolution. Each week studies show the risks and benefits of certain procedures or drugs to treat cardiovascular conditions, and this week, CABG surgery is in the hot seat.

The first study published in JAMA shows that surgeons may have to re-evaluate the use of radial artery grafts during CABG surgery after reporting that these graft may not show superior rates of angiographic patency at one year when compared with saphenous vein grafts.

In fact, the researchers reported that the one-year graft patency rates were identical for the two surgical methods, reaching almost 90 percent. In addition, one-week patency rates barely differed, as did the rates of serious adverse events.

The authors also found that patients who received saphenous vein grafts may have shorter lengths of stay, while the costs for radial artery grafts may be more expensive.

To add to the data surrounding CABG, a study published in Circulation this week showed that open vein harvesting may become a thing of the past after results showed that endoscopic vein harvesting methods did not decrease survival or increase harm.

Researchers from the Dartmouth-Hitchcock Medical Center found that the endoscopic harvesting technique increased the risk of bleeding; however, it decreased the risk of leg wound infections.

In addition, researchers from Brigham and Women’s Hospital in Boston, who use endoscopic vein harvesting during 95 percent of all procedures, wrote that “endoscopic vein harvesting is a safe and viable technique.”

And despite the fact that endoscopic vein harvesting may be much more expensive when compared with open vein harvesting, the researchers from Brigham said that open vein harvesting may become “obsolete” in a few years.

“You tell me that it's evolution. Well, you know, we all want to change the world,” the Beatles sang . Where do you think the future of CABG surgery is headed? What is your solution? Write in and let us know.

Kaitlyn Dmyterko
Staff Writer