Step 1: Read the strain as a percent change.
A longitudinal strain of $0.45$ just means the vein got $45\%$ longer than it started.
Step 2: Find the extra length gained.
The starting length is $20$ cm, so the extra length added is
\[ 0.45 \times 20 = 9 \text{ cm} \]
Step 3: Add the extension to the original length.
\[ L_f = 20 + 9 = 29 \text{ cm} \]
Step 4: Check the answer against the strain formula.
Using $e = (L_f - L_i)/L_i$, putting in $L_f = 29$ and $L_i = 20$ gives $e = 9/20 = 0.45$, which matches the value given in the question.
\[ \boxed{L_f = 29 \text{ cm}} \]