Successfully Navigating a First EVH Procedure
Since December 2023, Tara Byrne has been employed as a Cardiothoracic Advanced Nurse Practitioner at the University Hospital Galway in Ireland. She is also an Adjunct Clinical Lecturer in the Department of Nursing Studies and Midwifery at the Faculty of Education and Health Sciences at the University of Limerick. Her key responsibilities in her current role include the pre-surgical assessment of individuals awaiting heart and lung surgery, the management of post-operative in-patients, cardiothoracic consultation requests and the development of surgical skills. She is currently undertaking training in Endoscopic Vein Harvesting (EVH) which she believes is a key skill that contributes to positive patient outcomes for patients who require Coronary Artery Bypass Surgery. Moreover, Tara is a PhD Candidate in Digital Health Technology, studying at the Technological University of the Shannon. In 2015 she earned her Master's Degree in Nursing while studying at the Royal College of Surgeons in Ireland.
Eliziyanti Binti Safian currently works at the Institut Jantung Negara in Kuala Lumpur, Malaysia. Eliziyanti has been involved in cardiac surgery for more than 17 years, including four years as a scrub nurse in the cardiovascular operating room. Since first being qualified as a Registered Nurse in 2007 she has expanded her carrier development and currently serves as a certified Perioperative Surgeon Assistant, specializing in conduit preparation and assisting surgeons during cardiac surgery. Eliziyanti has always been fascinated by the intricate workings of the cardiovascular system and its role in overall health. She says she is committed to further developing her skills, keeping abreast of new techniques in healthcare, and contributing to advancements that lead to better patient outcomes. Since 2023 Eliziyanti has successfully completed 30 EVH cases.
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What was your experience like during your first Endoscopic Vein Harvesting (EVH) case and what do you think was most helpful in preparing for it?
Tara Byrne: "I have to say I had an extremely positive experience during my first EVH case. I feel that, to be honest, because of the structured program that Terumo has, I was extremely prepared for my first EVH case and that I feel gave me confidence. And the structured program meant, that I learned in my own way/ in many various different ways, such as practical hands on and videos and then the pre-training. So, I feel for me, I felt very prepared and very confident going in my first case and then having the benefits of having a proctor like Peter with me and overall it was an extremely positive experience for me."
Eliziyanti Binti: "My first EVH case I experienced with the blend of excitement, challenges, and immense learning. The comprehensive training, meticulous learning, equipment familiarity, mental preparation, and unwavering team support were instrumental in navigating this physical approachThe positive patient outcome and the personal satisfaction of mastering a new technique made the experience profoundly rewarding. So my key preparation that were most helpful in my first EVH case is comprehensive training. I got thorough training such as a detailed case review, my familiarity with the equipment I have some equipment familiarization, dry runs such as mental preparation, visualizing the process step by step help me mentally prepare for the surgery thing. I think this technique reduce anxiety and increase my focus. Engaging in mindfulness practices before the surgery help calm my nerve and maintain a steady hand during the procedure. The most important thing get the team support, collaborative environment."
Which features of the VirtuoSaph™ Plus EVH System were most beneficial throughout the case?
Tara Byrne: "For me as a novice harvester, I feel there's multiple - I call them ‘safety features’ on the Terumo kit and the first one is the Vein-lock where you have your vein secured once you capture it and you follow back. So, it's very difficult to miss any side branches with it, so makes your harvesting a lot easier. I also love that the knife is about 6mm from the vein, so the conduit itself, which means that when I am cutting a branch that I have secured, then, because of the fact that there is a 6mm distance, I am less likely to damage the vein. So, I think that gave me comfort in harvesting the vein and that's why I like the Terumo kit.
Eliziyanti Binti: "My personal honestly personal point of view, the features and benefit which was in the case that have is the safety oriented design, which include the bipolar electrocitical energy and the open C auto system. The second thing I think is the efficiency boosting mechanism, which integrated wiper mechanism like a built in wiper that cleans and clear the lens. The third one is innovative tools and accessories. The foruth one , I think I can give up the base, the enhanced visualisation and control like a centering rings."
If you could give one piece of advice to new clinicians doing their first EVH procedure, what would it be and why?
Tara Byrne: "For me, the best piece of advice that I would give would be to be patient with yourself and trust the process. Trust the structured program that is set out for you, and by the time you get to your first EVH case, you are very prepared for it and also trust your Proctor. The Proctor gives you a fantastic support and they are there for you throughout your whole journey. So trust the process will probably be my biggest piece of advice."
Eliziyanti Binti: "Comprehensive training, thorough preparation, supportive teamwork, and continuous learning is crucial for success. Embrace the learning curve with patient and dedication, and remember that each case will beat your confidence and skill in this advanced technique."
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