Is internal thoracic artery resistant to reperfusion injury? Evaluation of the storage of free internal thoracic artery grafts

Veres, Gábor; Schmidt, Harald; Hegedűs, Péter; Korkmaz‐Icöz, Sevil; Radovits, Tamás; Loganathan, Sivakkanan; Brlecic, Paige; Li, Shiliang; Kretzler, Matthias; Szabó, Gábor

doi:10.1016/j.jtcvs.2018.05.079

Cited by 16 publications

(7 citation statements)

References 33 publications

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“…To preserve endothelial integrity after harvesting, the grafts are temporarily stored in a preservation solution, including physiologic saline, autologous blood and buffered saline. The available preservation methods of the arterial/venous grafts do not sufficiently protect the endothelium and have a detrimental effect on it [9]. In the present study, an isolated tissue bath has allowed ex vivo evaluation of the adverse effects of IRI on vascular function.…”

Section: Discussionmentioning

confidence: 97%

Graft Preservation Solution DuraGraft® Alleviates Vascular Dysfunction Following In Vitro Ischemia/Reperfusion Injury in Rats

et al. 2021

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Vascular ischemia/reperfusion injury (IRI) in patients undergoing coronary artery bypass grafting can result in graft failure and the need for repeat revascularization procedures. DuraGraft® has been shown to protect structure and function in saphenous vein grafts against IRI. We compared the effect of DuraGraft® to saline solution on arterial grafts submitted to IRI. Rat thoracic aortic rings were harvested and immediately mounted in organ bath chambers (control, n = 7 rats) or underwent cold ischemic preservation either in saline (IR, n = 9 rats) or DuraGraft® (IR+Dura, n = 9 rats). Vascular function was measured ex vivo and immunohistochemistry was performed. Impaired maximum vasorelaxation (Rmax) to ACh in the IR-group compared to controls was ameliorated by DuraGraft®, indicating an improvement in endothelial function (Rmax to ACh (%): IR + Dura 73 ± 2 vs. IR 48 ± 3, p < 0.05). Additionally, decreased aortic ring sensitivity to ACh (pD2-value: -log 50% maximum response) seen after IR in the saline group was increased by DuraGraft® (pD2 to ACh: IR+Dura 7.1 ± 0.1 vs. IR 6.3 ± 0.2, p < 0.05). Impaired maximum contractile response to phenylephrine and high potassium chloride concentrations in the IR group compared to controls was significantly improved by DuraGraft®. DuraGraft® alleviates vascular dysfunction following IRI by reducing nitro-oxidative stress and the expression of ICAM-1, without leukocytes engagement.

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Section: Discussionmentioning

confidence: 97%

Graft Preservation Solution DuraGraft® Alleviates Vascular Dysfunction Following In Vitro Ischemia/Reperfusion Injury in Rats

et al. 2021

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“…The difference between free and in situ ITAs is also highlighted by the finding that bilateral ITA grafting demonstrates better results when both ITAs are used as in situ graft compared to the setup of applying the second ITA as a free graft ( 21 ). Our group has also shown in a porcine model of CABG that endothelial function and integrity were severely impaired in free ITA grafts after reperfusion, however in situ grafts showed no signs of injury ( 17 ). A major factor leading to poorer outcomes with free grafts is ischemia-reperfusion injury (IRI), which occurs during the harvest and implantation of these conduits.…”

Section: Discussionmentioning

confidence: 88%

“…The biological properties of ITA enable it to provide the most favorable outcomes in CABG. One of the beneficial components is the increased production of nitric oxide (NO) compared to other conduits ( 17 ), which is due to the rich heparin sulfate and endothelial nitric oxide synthase (eNOS) content of the endothelial cells of ITA. NO is an important factor of endothelial homeostasis ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

Zinc-aspirin preconditioning reduces endothelial damage of arterial grafts in a rodent model of revascularization

Benke,

Stengl,

Stark

et al. 2024

Front. Cardiovasc. Med.

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IntroductionCoronary artery bypass grafting (CABG) is the most common cardiac surgical procedure. The prognosis of revascularization via CABG is determined by the patency of the used grafts, for which an intact endothelium is essential. The degree of ischemia-reperfusion injury (IRI), which occurs during the harvest and implantation of the grafts, is an important determinant of graft patency. Preconditioning with aspirin, a nonsteroidal anti-inflammatory drug has been shown to reduce the functional and molecular damage of arterial grafts in a rodent model. Studies have found that the zinc-aspirin complex may be able to exert an even better protective effect in pathological cardiovascular conditions. Thus, our aim was to characterize the protective effect of zinc-aspirin complex on free arterial grafts in a rodent model of revascularization.MethodsDonor Lewis rats were treated with either zinc-aspirin, aspirin, or placebo (n = 8) for 5 days, then the aortic arches were harvested and stored in cold preservation solution and implanted heterotopically in the abdominal cavity of the recipient rats, followed by 2 h of reperfusion. There was also a non-ischemia-reperfusion control group (n = 8). Functional measurements using organ bath and histomorphological changes using immunohistochemistry were analyzed.ResultsThe endothelium dependent maximal vasorelaxation was improved (non-transplanted control group: 82% ± 3%, transplanted control group: 14% ± 2%, aspirin group: 31% ± 4%, zinc-aspirin group: 52% ± 4%), the nitro-oxidative stress and cell apoptosis decreased, and significant endothelial protection was shown in the groups preconditioned with aspirin or zinc-aspirin. However, zinc-aspirin proved to be more effective in the reduction of IRI, than aspirin alone.DiscussionPreconditioning with zinc-aspirin could be a promising way to protect the function and structural integrity of free arterial grafts, thus improving the outcomes of CABG.

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“…In addition, our group previously demonstrated a dramatically reduced endothelial function (reduced endothelial-dependent vasodilatation, impaired NO production etc.) of the free arterial graft after short/mid-term reperfusion in various experimental models [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Aspirin Reduces Ischemia-Reperfusion Injury Induced Endothelial Cell Damage of Arterial Grafts in a Rodent Model

et al. 2022

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Long-term graft patency determines the prognosis of revascularization after coronary artery bypass grafting (CABG). Ischemia-reperfusion (I/R) injury of the graft suffered during harvesting and after implantation might influence graft patency. Aspirin, a nonsteroidal anti-inflammatory drug improves the long-term patency of vein grafts. Whether aspirin has the same effect on arterial grafts is questionable. We aimed to characterize the beneficial effects of aspirin on arterial bypass grafts in a rodent revascularization model. We gave Lewis rats oral pretreatment of either aspirin (n = 8) or saline (n = 8) for 5 days, then aortic arches were explanted and stored in cold preservation solution. The third group (n = 8) was a non-ischemia-reperfusion control. Afterwards the aortic arches were implanted into the abdominal aorta of recipient rats followed by 2 h of reperfusion. Endothelium-dependent vasorelaxation was examined with organ bath experiments. Immunohistochemical staining were carried out. Endothelium-dependent maximal vasorelaxation improved, nitro-oxidative stress and cell apoptosis decreased, and significant endothelial protection was shown in the aspirin preconditioned group, compared to the transplanted control group. Significantly improved endothelial function and reduced I/R injury induced structural damage were observed in free arterial grafts after oral administration of aspirin. Aspirin preconditioning before elective CABG might be beneficial on free arterial graft patency.

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Is internal thoracic artery resistant to reperfusion injury? Evaluation of the storage of free internal thoracic artery grafts

Abstract: An early, severe endothelial dysfunction of the stored, free ITA as described, could be completely prevented by the use of an in situ ITA graft. Tiprotec might be a feasible option for storage of free arterial grafts during coronary artery bypass grafting.

Cited by 16 publications

References 33 publications

Graft Preservation Solution DuraGraft® Alleviates Vascular Dysfunction Following In Vitro Ischemia/Reperfusion Injury in Rats

Graft Preservation Solution DuraGraft® Alleviates Vascular Dysfunction Following In Vitro Ischemia/Reperfusion Injury in Rats

Zinc-aspirin preconditioning reduces endothelial damage of arterial grafts in a rodent model of revascularization

Aspirin Reduces Ischemia-Reperfusion Injury Induced Endothelial Cell Damage of Arterial Grafts in a Rodent Model

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