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Endothelial preservation of the minimally manipulated saphenous vein composite graft: Histologic and immunohistochemical study

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Authors
Hwang, Ho Young; Kim, Min-A; Seo, Jeong Wook; Kim, Ki-Bong
Issue Date
2012-12
Publisher
MOSBY-ELSEVIER
Citation
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY Vol.144 No.3, pp. 690-696
Keywords
복합학
Abstract
Objective: We evaluated the efficacy of minimally manipulative surgical strategies to harvest the saphenous vein for use in a Y-composite graft based on the left internal thoracic artery in terms of preservation of endothelial structure and function.Methods: Twenty patients who underwent off-pump coronary revascularization using the saphenous vein in a Y-composite graft based on the left internal thoracic artery were studied. The saphenous vein was harvested from each patient with minimal manipulation. An excess saphenous vein segment was removed before dilatation (control group), and a second segment was removed after dilation performed using a pressure-sensing syringe (conventional group). A third segment was obtained from a Y-composite vein graft dilated by flow and pressure from the left internal thoracic artery (composite group). Hematoxylin-eosin staining and immunohistochemistry using antibodies against CD31, CD34, von Willebrand factor, and endothelial nitric oxide synthase were performed. A generalized estimating equation was adopted for statistical analysis.Results: Histologic and immunohistochemical studies revealed better endothelial preservation in the composite and control groups than in the conventional group (P < .01 in each). The composite group saphenous vein showed a lower grade of endothelial integrity than the control group saphenous vein based on hematoxylin-eosin staining, CD34 immunohistochemistry, and nitric oxide synthase staining (P < .001 in each).Conclusions: Harvesting of the saphenous vein using minimal manipulation for use in a Y-composite graft based on the left internal thoracic artery preserved endothelial structure and function when compared with manually dilated saphenous vein harvesting. (J Thorac Cardiovasc Surg 2012;144:690-6)
Objective: We evaluated the efficacy of minimally manipulative surgical strategies to harvest the saphenous
vein for use in a Y-composite graft based on the left internal thoracic artery in terms of preservation of endothelial
structure and function.
Methods: Twenty patients who underwent off-pump coronary revascularization using the saphenous vein in
a Y-composite graft based on the left internal thoracic artery were studied. The saphenous vein was harvested
from each patient with minimal manipulation. An excess saphenous vein segment was removed before dilatation
(control group), and a second segment was removed after dilation performed using a pressure-sensing syringe
(conventional group). A third segment was obtained from a Y-composite vein graft dilated by flow and pressure
from the left internal thoracic artery (composite group). Hematoxylin–eosin staining and immunohistochemistry
using antibodies against CD31, CD34, von Willebrand factor, and endothelial nitric oxide synthase were performed.
A generalized estimating equation was adopted for statistical analysis.
Results: Histologic and immunohistochemical studies revealed better endothelial preservation in the composite
and control groups than in the conventional group (P<.01 in each). The composite group saphenous vein
showed a lower grade of endothelial integrity than the control group saphenous vein based on hematoxylin–eosin
staining, CD34 immunohistochemistry, and nitric oxide synthase staining (P<.001 in each).
Conclusions: Harvesting of the saphenous vein using minimal manipulation for use in aY-composite graft based
on the left internal thoracic artery preserved endothelial structure and function when compared with manually
dilated saphenous vein harvesting.
ISSN
0022-5223
Language
English
URI
http://hdl.handle.net/10371/80107
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)Journal Papers (저널논문_의학과)
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