Endoscopic Harvesting in Coronary Artery Bypass Grafting.

Study Overview
=================
Brief Summary
-----------------
This is a retrospective data collection looking at patients who received either an endoscopic vessel harvesting procedure versus the conventional open procedure. Besides looking at cost variables in the 2 groups, other outcomes of interest include length of hospital stay, rates of infection, medication use, re-admissions and compilations.

Detailed Description
-----------------
Since April 2018, the study database has been updated with all patients (currently there are 340 patients per group) and variables - both reflecting effectiveness of the procedure and cost. Preoperative variables being captured include comorbidity factors and variables relating to the Society of Thoracic Surgery (STS) score , which is a pre-procedure assessment of surgical risk. The postoperative data collection includes a variety of complications and comorbidities the patient could experience during their hospital stay. These variables will provide us with information regarding procedure effectiveness, patient recovery and further costs associated with the procedure. Medications and antibiotics provided during the stay are also being captured. Total hospital costs will include any costs associated with ward stay, separated per level of care: Intensive Care Unit (ICU), Cardiac Surgical Unit (CSU), and regular ward. The two follow up periods are 30 days and 6 months. Both look at the same effectiveness variables, any emergency room (ER) visits, re-admissions, and their respective reasons. Quality of life will be obtained by looking at the number of complications the patient experienced during these periods. The frequency of home care services provided to each patient, if any, are also being tracked. Cost calculations will be done by obtaining the time, length and number of visits to the ER, re-admissions and clinic visits.

Official Title
-----------------
Endoscopic Harvesting of the Radial Artery and Saphenous Vein Grafts in Coronary Artery Bypass Surgery.

Conditions
-----------------
Graft Infection, Coronary Bypass Stenosis

Intervention / Treatment
-----------------
* Device: Medtronic endoscope


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: any patient at the KHSC undergoing a CABG procedure requiring a vein graft. Exclusion Criteria: undergoing a simultaneous procedure.

Ages Eligible for Study
-----------------
Minimum Age: 19 Years
Maximum Age: 100 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Open vessel harvesting<br>Arm 1 is the conventional procedure | Device: Medtronic endoscope<br>* The endoscope is a minimally invasive tool used to remove veins from the leg traditionally used for CABG.<br>|
| Experimental: Medtronic endoscope<br>Arm 2 - is the minimally invasive procedure | Device: Medtronic endoscope<br>* The endoscope is a minimally invasive tool used to remove veins from the leg traditionally used for CABG.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cost analysis | economic cost of open versus endoscopic vessel harvesting | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of stay | days beyond normal length of stay | 2 days | 
| infection | infection of graft harvesting site | 6 months |