Evaluation of endoscopic vein extraction on structural and functional viability of saphenous vein endothelium

Hussaini, Bader E.; Lu, Xiangyi; Wolfe, J. Alan; Thatte, Hemant S.

doi:10.1186/1749-8090-6-82

Cited by 33 publications

(32 citation statements)

References 24 publications

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“…19 Furthermore, endothelial injury leads to enhanced medial smooth muscle proliferation and migration, as well as activation of a cascade of mediators governing inflammation and oxidative stress, resulting in accelerated intimal hyperplasia. 1, 22–24 In this investigation, storage in all solutions except autologous whole blood and GALA led to a decrease in endothelial-dependent relaxation compared to UP control. Autologous whole blood preservation exposed the fragile endothelium to a minimally perturbed microenvironment where it was exposed to the same composition of growth factors, proteins and electrolytes as in vivo .…”

Section: Discussionmentioning

confidence: 61%

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Preservation solution impacts physiologic function and cellular viability of human saphenous vein graft

Wise

Hocking

Eagle

et al. 2015

Surgery

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Introduction Recent clinical data suggests intraoperative preservation of human saphenous vein (HSV) in normal saline is associated with vein graft failure. We evaluated the influence of several preservation media on acute physiologic function and cellular viability of HSV conduit. Methods Unprepared (UP) HSV obtained from coronary artery bypass graft patients was characterized on a muscle bath after two hour storage in Plasma-Lyte A, normal saline, University of Wisconsin solution, Celsior solution, autologous whole blood, or glutathione-ascorbic acid- L-arginine (GALA) solution. Vascular smooth muscle contractility to depolarizing KCl and phenylephrine was assessed. The relaxation of phenylephrine-pre-contracted HSV to sodium nitroprusside and carbachol (endothelial-independent and -dependent relaxation, respectively) was also assessed. Cellular viability was determined via the methyl thiazolyl tetrazolium (MTT) assay. Rat aortae were used to assess the effect of pH during graft preservation on endothelial-dependent relaxation. Results Preservation of HSV in normal saline and autologous whole blood impaired contractile responses to KCl relative to UP tissues, while University of Wisconsin solution and Celsior solution preservation enhanced contractile responses (P<.05). Relative to UP tissues, responses to phenylephrine were decreased with preservation in normal saline, while preservation in University of Wisconsin solution, Celsior solution and GALA all potentiated these responses (P<.05). Only normal saline preservation impaired endothelial-independent relaxation (P=.005). Preservation in Plasma-Lyte A (P=.02), normal saline (P=.002) and University of Wisconsin solution (P=.02) led to impaired endothelial-dependent relaxation. Normal saline preservation led to a decreased MTT viability index relative to UP tissues (0.021±0.002 mg−10.5 mL−1 vs. 0.033±0.005 mg−10.5 mL−1; P=.03). Endothelial function was impaired by acidic pH in rat aorta. Conclusions Normal saline preservation causes graft injury leading to impaired physiologic function and decreased viability of HSV. This harm to the conduit is mitigated by the use of buffered salt solutions as preservation media.

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Section: Discussionmentioning

confidence: 61%

“…1 During typical intraoperative preparation, HSV is subject to a series of “back-table” manipulations. One such manipulation is preservation in a storage medium prior to implantation.…”

Section: Introductionmentioning

confidence: 99%

Preservation solution impacts physiologic function and cellular viability of human saphenous vein graft

Wise

Hocking

Eagle

et al. 2015

Surgery

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“…It is believed that this oedema may be due to partial interruption of lymphatic drainage due to the long incision needed to harvest the vein in the OVH group. Injection preparations of lower extremity have shown that the superficial lymphatics run in a narrow band of adipose tissue overlying the great saphenous vein and do not communicate with the deep lymphatics [10]. Although EVH does not prevent development of lower extremity oedema, lack of incisions in an edematous leg with obstructed lymphatics may play a role in preventing localized wound dehiscence and cellulitis.…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative risk factors normally associated with leg wound complications include female gender, diabetes mellitus, obesity, hypoalbuminemia, anaemia, peripheral vascular disease, chronic ischemia and steroid use [9,10]. The cause of wound complications and more importantly infections is not completely understood [6].…”

Section: Discussionmentioning

confidence: 99%

A prospective randomized trial of endoscopic versus open saphenous vein harvesting technique for coronary artery bypass graft surgery

Kalra

Aiyer

Bhardwaj

et al. 2016

Indian J Thorac Cardiovasc Surg

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Purpose The great saphenous vein harvested with a traditional open technique often results in leg wound complications.An endoscopic harvesting technique may decrease incidence of these complications. Methods and material Fifty consecutive patients having elective primary coronary artery bypass surgery were prospectively and randomly assigned to either endoscopic great saphenous vein harvesting (EVH-group A) or open great saphenous vein harvesting (OVH-group B). Both groups were demographically similar and received identical management. Leg wound healing was evaluated at discharge, 1 week, 1 month and 6 months for evidence of complications. Result The patient in endoscopic vein harvesting group had increased harvest time and an insignificant increase in vein injuries at the time of harvesting but decreased incision closure times when compared with traditional longitudinal open vein harvesting. Conversion from endoscopy to a traditional longitudinal open vein harvest occurred in 5 % of patients. Leg wound complications were significantly reduced postoperatively in the endoscopic vein harvesting group in comparison with the open vein harvesting group. Histological evaluation of structural integrity of vein samples shows that there is no significant difference between both the groups. No patient was readmitted to the hospital for leg wound complications in either group.Conclusion EVH is a safe, reliable method for saphenous vein harvesting. The best indication for EVH may be in patients who are in increased risk for wound infection and in whom cosmetics is a major concern.

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“…They found that western blots, immunofluorescent, multiphoton imaging had no difference for caveolin 1, eNOS, Cadherin, and vWf between EVH and OVH [13]. …”

Section: Discussionmentioning

confidence: 99%

Immunohistochemistry comparing endoscopic vein harvesting vs. open vein harvesting on saphenous vein endothelium

Nezafati

Amoueian

et al. 2014

J Cardiothorac Surg

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ObjectiveThe present study attempts to compare the immunohistochemistry (IHC) of von Willebrand factor (vWf) , endothelial cadherin, Caveolin and endothelial Nitric Oxide Synthase (eNOS) in VasoView Endoscopic Vein Harvesting (EVH) versus traditional Open Vein Harvesting (OVH) techniques for Coronary Artery Bypass Graft (CABG) Surgery performed in Javad al Aemeh Hospital of Mashhad, Iran in 2013,.Methods and materialsForty-seven patients were scheduled for CABG (30 EVH and 17 OVH) among whom patients with relatively same gender and similar age were selected. Three separate two cm vein samples were harvested from each patient’s saphenous vein. Each portion was collected from distal, middle and proximal zones of the saphenous vein. The tissues were deparaffinized, and antigen retrieval was done using EZ-retriever followed by an immunohistochemistry evaluation with vWf, e-cadherin, Caveolin and eNOS. In addition, demographic questioner as of Lipid profile, FBS, BMI, and cardiovascular risk factors were collected. Data analyses, including parametric and nonparametric tests were undertaken using the SPSS 16 software. A P value < 0.05 was regarded as statistically significant.ResultsThe mean age of the EVH and OVH groups were 63.76 ± 9.51 and 63.63 ± 8.31 years respectively with no significant difference between them (p = 0.989). In addition, there was no great difference between the EVH and OVH groups in lipid profile, DM, HTN, smoking history, CVA, and valvular dysfunction (P > 0.05). Qualitative report of vWf, e-cadherin, Caveolin and eNOS reveals no significant difference between the EVH and OVH (P > 0.05).ConclusionThis study indicates that VasoView EVH technique causes no endothelial damage in comparison with OVH. This study could be a molecular confirmation for the innocuous of EVH technique.

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Evaluation of endoscopic vein extraction on structural and functional viability of saphenous vein endothelium

Cited by 33 publications

References 24 publications

Preservation solution impacts physiologic function and cellular viability of human saphenous vein graft

Preservation solution impacts physiologic function and cellular viability of human saphenous vein graft

A prospective randomized trial of endoscopic versus open saphenous vein harvesting technique for coronary artery bypass graft surgery

Immunohistochemistry comparing endoscopic vein harvesting vs. open vein harvesting on saphenous vein endothelium

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