Coronary artery bypass grafting (CABG) remains the most commonly performed cardiac surgical procedure worldwide. The long saphenous vein (LSV) and radial artery (RA) continue to compete as the second graft in multi-vessel CABG surgery. Traditionally, both conduits have been harvested with an open approach, which involves a long incision along the medial part of the thigh, leg and forearm. This open approach is associated with significant wound complications, including post-operative pain, infection and delayed wound healing, resulting in significant prolongation of in-hospital length of stay and requirement of community wound care. Endoscopic vein harvesting (EVH) and endoscopic radial artery harvesting (ERAH) are minimally invasive harvesting techniques, which requires a single 2-3 cm incision and is associated with a quicker return to normal daily activities, decreased wound complications and better quality of life in the longer term. Coronary artery bypass grafts experience stress due to handling during harvesting processes, oxidative stress, post-harvest ischemia, reperfusion injury and adaptive stress in new environments. This contributes to early graft failure through intimal hyperplasia, thrombosis and atherosclerosis. While minimally invasive harvesting techniques greatly improve the patient peri-operative experience, the hypothesis of our study is, endoscopically harvested vessels undergo less trauma in comparisons to the open approach and our study aims to assess each endoscopically harvested graft for histological evidence of trauma, in comparison to conduits harvested through an open approach. We will preform an observational study on patients undergoing CABG surgery with both the RA and LSV. 20 patient will be recruited. The ratio of endoscopic harvest: open surgery will be 3:1. The project commences on the 1st of July 2023. The procedure includes excision of 2×2 mm rings from each conduit and each will be stored in Duragraft or heparinized lactated ringer’s solution. After 60 minutes, both specimens will be sent for histological diagnosis.
