Terumo Cardiovascular Systems

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Best Practices

Information provided on this website is not intended to make claims that the products are safe and effective for any use other than those explicitly described in the Instructions for Use. Clinicians should refer to the Instructions for Use or Owner's Manuals for complete information on the intended use of any product mentioned in this website.

STUDY: Extent of Thermal Injury in Vascular Conduits Using VirtuoSaph Endoscopic Vein Harvesting System in Swine
A. Rojas, MD, et al, University of Michigan, tested the Virtuosaph System in swine model using open technique on arteries and veins to assess extent of thermal spread during branch ligation

CASE STUDY: A Comparative Study of Endoscopic Vein Harvesting Systems
Jeffrey D'Agostino, M.S., PA-C, St. Barnabas Healthcare System, and clinicians at two other metro New York hospitals, undertook a study to compare two EVH systems over 48 cases to determine the extent of thermal injury and to verify vein branch length.

UPDATE: News from APACVS
Latests news from Association of Physician Assistants in Cardiovascular Surgery

CASE STUDY: Jose Sosa, OR Manager in Jackson, MS, Thrives in Role as Teacher
Mississippi Hospital a Key Training Ground for Future PA-Cs Interested in Learning Vessel Harvesting

CLINICAL DISCUSSION OUTLINE: Team Communication Can Optimize Conduit Quality
Mark Schumacher, PA-C, encourages surgical teams to use a clinical discussion outline before a case, as recommended by Terumo CVS' senior clinical specialist, Michael Fortunato, PA-C.

CD-ROM: Extent of Thermal Injury in Vascular Conduits: A Comparison of Two Common EVH Devices in an Animal Model
Order a CD-ROM of the presentation by Alvaro Rojas-Peña, MD, recorded at the Terumo workshop during the Winter 2010 APACVS Meeting, concerning his study of thermal injury in vascular conduits.

CD-ROM: Saphenous Vein Harvest Best Practice - "Back Table and Beyond"
Order a CD-ROM of the presentation by Michael Gardocki, PA-C, FAPACVS, recorded at the Terumo workshop during the Winter 2010 Meeting of the Association of Physician Assistants in Cardiovascular Surgery.

CD-ROM: Comparative EVH Systems Study
Order a CD-ROM of the presentation by Jeffrey D'Agostino M.S., PA-C, recorded at the Terumo workshop during the Winter 2010 APACVS Meeting, in which he discusses his comparative EVH systems study.

CD-ROM: Best Practices - Preoperative Considerations/Planning Strategies for Optimal Conduits
Order a CD-ROM of the presentation by Jonathan Sobel, RPA-C, FAPACVS, recorded at the Terumo workshop during the Winter 2010 APACVS Meeting, in which he discusses preoperative considerations and planning strategies.

CD-ROM: Intra-Operative EVH Best Practices
Order a CD-ROM of the presentation by Bob Langford, PA-C, recorded at the Terumo workshop during the Winter 2010 APACVS Meeting, in which he discusses best practices for intra-operative EVH.

ABSTRACT: Quantification of thermal spread and burst pressure after endoscopic vessel harvesting: A comparison of two commercially available devices J. Thorac Cardiovasc Surg. 2011; 142: 203-208 Rojas-Pena A, Koch KL, Heitner HD, Hall CM, Bergin IL, Cook KE
This study was performed to examine the extent of thermal injury caused by two commercially available EVH systems in a porcine model.

RESEARCH: More articles continue the EVH vs. Open Debate
Articles published subsequent to the 2009 NEJM article on the topic of open vs. traditional EVH.

ABSTRACT: Strategies to Reduce Intraluminal Clot Formation in Endoscopically Harvested Saphenous Veins. J Thoracic Cardiovasc Surg. 2007; 134:1259-1265. Brown, E. et al.
In this 40-patient study, intraluminal saphenous vein clot formation was compared between endoscopic vein harvesting systems. Results indicate that systemic heparanization and an open system can lessen this complication.

ABSTRACT: Continuous Graft Perfusion: Optimizing the Quality of Saphenous Vein Grafts. Heart Surgery Forum. 2002;5(4);S355-S361. Lamm, P et al.
In this 80-patient study, conventional vein harvest was compared to EVH and endothelial integrity was found to be superior when using EVH.

ABSTRACT: Carbon Dioxide Embolism During Endoscopic Saphenous Vein Harvesting in Coronary Artery Bypass Surgery. J Thorac Cardiovasc Surg. 2003; 126:2011-2015. Lin, T et al.
In this 403-patient study, the incidence of significant CO2 embolism during EVH with CO2 insufflation procedures was more than 4% and that continuous monitoring was essential in early detection.

ABSTRACT: The Transition From Open to Endoscopic Saphenous Vein Harvesting and its Clinical Impact; Texas Heart Institute Journal 2006;33:316-320. Lai, T et al.
This retrospective study of 1,573 procedures concluded that EVH reduces leg wound infections, is safe and reliable, and should be the standard of care for CABG procedures.

ABSTRACT: Randomized Trial of Endoscopic Versus Open Vein Harvest for Coronary Artery Bypass Grafting: Six Month Patency Rates. Journal of Thoracic and Cardiovascular Surgery 2005;129:496-503. Yun, K et al.
This 200-patient study concluded that EVH reduces leg wound complications as compared to open technique without compromising the 6-month patency rate.

VIDEO: EVH Best Practices - Dissection (60 sec.)
Focusing on patient leg position, clinician hand position on dissector and starting the dissection process.

VIDEO: EVH Best Practices - Finding The Vein (2:48 mins.)
This short video demonstrates one method of locating the saphenous vein pathway with minimal use of scissors.

VIDEO: Branch Capture
Branch capturing is a more advance technique used to isolate saphenous vein branches for transection

VIDEO: Terumo Method with VirtuoSaph® Plus Endoscopic Vessel Harvesting (3:02)
This short video demonstrates the Terumo Method of vessel harvesting.

VIDEO: Stab and Grab
By doing the "stab and grab" first, the need to go back up the tunnel once the harvester has transected all of the side branches is negated.