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A Journal on Cardiac, Vascular and Thoracic Surgery

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The Journal of Cardiovascular Surgery 2003 December;44(6):707-11

language: English

Neurologic symptoms after great saphenous vein harvesting for coronary artery bypass grafting

Budillon A. M., Zoffoli G., Nicolini F., Agostinelli A., Congiu S., Beghi C., Gherli T.

Depart­ment of Car­diac Sur­gery, Uni­ver­sity of ­Parma, ­Parma, ­Italy

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Aim. Inci­dence eval­u­a­tion of cuta­neous neu­ro­logic symp­toms in the ­lower ­limbs as a new ­event ­after ­great saph­e­nous ­vein (GSV) har­vesting for cor­o­nary ­artery bypass ­grafting (­CABG). ­Each day we har­vest the GSV for ­CABG. ­Some ­authors ­have ­reported the ­onset of saph­e­nous neu­ralgia com­plex as a new ­event of ­which we ­would eval­uate the inci­dence.
­Methods. ­From Jan­uary 2000, ­until ­June 2001, 2 091 ­patients under­went car­diac sur­gery; 1 326 under­went ­CABG, 1 227 of ­them ­using the GSV as a con­duit for ­almost one ­graft. ­These ­patients ­were pros­pec­tively ­reviewed; all ­were preoper­a­tively exam­ined to deter­mine the pres­ence of ­normal sen­sa­tion in the ­lower ­limbs and ­elude the pres­ence of saph­e­nous neu­ralgia. ­Then, we eval­u­ated sen­sa­tions in the ­lower ­limbs at 5 ­days, 8 ­weeks, and 5 ­months ­after oper­a­tion to deter­mine the new ­onset of saph­e­nous neu­ralgia. The ­areas of sen­sory ­loss ­were ­recorded ­each ­time and ­reported in a dia­gram to ­obtain 3 ­areas.
­Results. Hyper­aes­thesia and ­pain ­were ­noted in a few ­patients, espe­cially at 5 ­days and 8 ­weeks con­trol, but at 5 ­months ­none of ­them com­plained of ­real ­pain.
Con­clu­sion. ­This ­study dem­on­strates ­that saph­e­nous neu­ralgia ­after har­vesting the GSV for ­CABG is a ­rare con­se­quence. The ­main ­symptom is ­anaesthesia but its dura­tion is gen­er­ally no ­longer ­than 2 ­months. Hyper­aes­thesia and ­pain, for the ­early ­onset and the ­early dis­ap­pear­ance, are con­sid­ered as a ­normal con­se­quence of sur­gical pro­ce­dure.

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