Prevention and Management of Ischemic Complications of Vein Harvest Incisions in Cardiac Surgery— Case Reports

Abstract

Leg wound complications following saphenous vein harvest for coronary re vascularization are uncommon. We have encountered five patients in whom unrecognized arterial occlusive disease contributed to wound necrosis. All re quired vascular reconstruction in addition to local wound care to achieve heal ing. Careful preoperative attention to symptoms of arterial insufficiency is recommended and appropriate modification of lower extremity incisions may reduce the frequency of this complication. Prompt recognition and appropriate arterial revascularization should avoid prolonged morbidity if ischemic necrosis of leg wounds does occur. If arterial reconstruction is required, PTFE is an acceptable graft material if the remaining saphenous vein is inadequate for use.