Reviewed by Varnada Karriem-Norwood on August 30, 2012
Matthew Thompson, Cardiac Physician Assistant, St. John’s Hospital, Los Angeles, CA.Kathy E. Maglite, MD, MBA, FACS; Director of Women’s Cardiac Surgical Services, St. John’s Hospital, Los Angeles, CA
© 2006 WebMD, Inc. All rights reserved.
Matthew Thompson: My function is to harvest or to obtain conduits that can be used to bypass or go around, circumvent obstructions that occur in coronary arteries.
Narrator: On this day, Thompson's patient is Raymond Goldsmith. Thompson is removing a healthy vein from Raymond's leg so it will be ready for Raymond's quadruple bypass operation. In order to get blood to the heart muscle of a by-pass patient more efficiently, surgeons first need to borrow veins or arteries from non-critical areas of the body and then stitch them into the vascular network supplying the heart muscle — re-routing the blood-flow around the blockage. This is called a graft.
Matthew Thompson: It's just L.A. traffic — it's like being stuck on the 405 and getting off and going around on a different route
Narrator: When an artery is needed it's usually taken from the patient's chest during the by-pass surgery itself. When a vein is required, surgeons normally tap the patient's leg. The process, referred to as vein harvesting, has saved many lives but has an aesthetic down side:
Raymond Goldsmith: I've seen a lot of results from vein harvesting. Legs look like, you know, rivers and tributaries.
Narrator: Not to mention the pain from recovering from being cut stem-to-stern. However, in a few hospitals across the country like Saint John's are now using Endoscopic technology
Raymond Goldsmith: Make an incision that's like an inch and a half.
Matthew Thompson: I use that C-ring to kind of move the primary vein out of the way.
Narrator: Doctors use a tiny fiber-optic camera and long, narrow instruments that they tunnel through a small incision to remove the vein with minimal trauma to the leg. Traditional methods make a much longer cut — often from the ankle to groin.
Matthew Thompson: So if we can take that long incision and narrow it down to a single small incision of one or two centimeters, the chances of infections or problems in healing are much reduced.
Narrator: Once the surgical team has the vein, or conduit, they can then perform the by-pass itself:
Matthew Thompson: We're sewing this vein to that artery.
Narrator: Raymond's operation was a success…
Raymond Goldsmith: If you can be happy with a surgery, I'm ecstatic.
Narrator: And the scar from the vein harvesting a small price to pay for Raymond's new lease on life.
Raymond Goldsmith: As I told my doctor, I have another 15 or 20 years to abuse my body…but I was only kidding.
Narrator: For WebMD, I'm Damon Meharg.