REGROUP Reassures About Endoscopic Saphenous Vein Harvesting in CABG (Video)

“A big sigh of relief for the cardiovascular community.” That’s how Cleveland Clinic cardiothoracic surgeon Faisal Bakaeen, MD, characterizes results of the REGROUP trial comparing endoscopic and open harvesting of vein grafts for coronary artery bypass graft surgery (CABG).

Dr. Bakaeen is a leading co-author of the multicenter trial, which was published online by the New England Journal of Medicine concurrent with its presentation as a late-breaking trial at the 2018 American Heart Association Scientific Sessions in Chicago. The 1,150-patient prospective randomized investigation eased lingering concerns about the safety and efficacy of using saphenous vein grafts harvested endoscopically versus those harvested via open techniques, finding no significant difference in rates of major adverse cardiac events between the two harvesting methods.

In the five-minute video below, Dr. Bakaeen explains the rationale and context for the trial and its implications for CABG practice moving forward, including the importance of the experience of the harvester for optimal outcomes with endoscopic harvesting.

“This study randomized patients undergoing coronary artery bypass grafting, or CABG, into veins harvested either and endoscopically… versus the traditional open approach, which typically involves skin incisions separated by bridges and sometimes out of necessity a long skin incision. The impetus of the study was really the question that was lingering in the cardiovascular community about the safety and efficacy of using less invasive means of taking the vein, which continues to this day to be the most common conduit used to supplement the left internal mammary artery bypass to the left anterior descending artery… There was a question of whether using a minimally invasive technique with an endoscope would harm the vein and result in bad outcomes. So the REGROUP trial is the largest multicenter prospective randomized trial on this subject.”