Pressure applied during surgery alters the biomechanical properties of human saphenous vein graft

Öztürk, Necla; Sucu, Nehir; Çömelekoğlu, Ülkü; Yılmaz, Banu Coşkun; Aytaçoğlu, Barlas Naim; Vezir, Özden

doi:10.1007/s00380-012-0245-6

Cited by 20 publications

(18 citation statements)

References 35 publications

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“…Several mechanisms seem to be behind the success of NT vein grafts: the decreased risk of graft spasm and the associated requirement for graft dilatation limits endothelial cell loss and resultant long-term damage. 27,28 Other aspects are the preservation of the vasa vasorum, which allows retrograde blood flow from the graft lumen to perfuse through the vein wall, thereby decreasing transmural ischemic damage, and preservation of endothelial nitric oxide synthase, 29 which is known to decrease intimal hyperplasia, subsequent atherosclerosis, and long-term graft failure. 30 Furthermore, the perivascular tissue may act as a natural external stent, reducing the neointimal and medial thickening of the vein graft, 31,32 and preventing it from kinking, which is especially important when using sequential grafts.…”

Section: Discussionmentioning

confidence: 99%

The no-touch saphenous vein for coronary artery bypass grafting maintains a patency, after 16 years, comparable to the left internal thoracic artery: A randomized trial

Samano

Geijer

Lidén

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

246

185

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Section: Discussionmentioning

confidence: 99%

The no-touch saphenous vein for coronary artery bypass grafting maintains a patency, after 16 years, comparable to the left internal thoracic artery: A randomized trial

Samano

Geijer

Lidén

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

246

185

View full text Add to dashboard Cite

show abstract

“…A number of underlying mechanisms have been suggested as contributories to the success of NT vein grafts. For example, the decreased risk of graft spasm and the associated requirement for graft distension reduces endothelial cell loss and the resulting long-term damage (20,32,33). Other aspects include the preservation of the vasa vasorum [allowing retrograde blood flow from the graft lumen to perfuse through the vein wall ( Figure 1)], thereby maintaining transmural flow and reducing ischemic damage (34).…”

Section: No-touch (Nt) Harvesting Techniquementioning

confidence: 99%

No-touch vein grafts and the destiny of venous revascularization in coronary artery bypass grafting—a 25th anniversary perspective

Samano

Dashwood

Souza

2018

Ann. Cardiothorac. Surg.

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Ischemic heart disease is currently the leading cause of death globally, with coronary artery bypass grafting among the most common operations performed worldwide. More extensive use of arterial grafts has been advocated because of their high long-term patency, long-term survival benefit, and freedom from reinterventions. Despite this, the saphenous vein is the most frequently used conduit in patients undergoing coronary artery bypass surgery since its introduction over 50 years ago. Consequently, the saphenous vein remains an indispensable conduit in coronary artery bypass grafting and maintaining its long-term patency is one of the most crucial challenges in cardiovascular surgery. This situation led to the development of the no-touch saphenous vein harvesting technique, where the vein is harvested completely with its pedicle of surrounding tissue. Several studies report a superior long-term patency rate, slower progression of atherosclerosis, and better clinical outcomes whilst employing no-touch harvesting technique. The success of the technique is multifactorial, including the decreased risk for graft spasm-and the need for manual distension-preservation of the vaso vasorum and an intact endothelium, reducing neointimal hyperplasia and subsequent atherosclerosis. Furthermore, the intact perivascular tissue, including the surrounding cushion of fat, may act as a "natural external stent", providing mechanical support preventing the graft from kinking. We are convinced that the use of arterial grafts, in combination with the no-touch saphenous vein graft, will significantly improve the results of coronary artery bypass grafting. This is important for achieving a comprehensive and evidence-based balance between the major treatment strategies of ischemic heart disease, explicitly coronary artery bypass grafting and percutaneous coronary intervention. The no-touch technique is becoming increasingly popular among surgeons, with further studies to be initiated worldwide.

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“…Saphenous vein segments were collected from 36 patients undergoing CABG surgery, and distended with a pressure in ranged 50-60, 75-100 and 130-150mmHg, and the ring-shaped samples were tested on a uniaxial material testing machine to get the circumferential stress-strain curves [95].…”

Section: Specimens Of Bovine Jugular and Lumbar Veins Harvested Circumentioning

confidence: 99%

Biomechanical property and modelling of venous wall

2018

Progress in Biophysics and Molecular Biology

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Human saphenous vein has long been used as coronary artery bypass grafts to survive a heart arrested by blocked coronary arteries. Biomechanical properties of the saphenous vein can be critical because mismatch in the biomechanical property between a coronary artery and a graft will reduce graft patency and speed up disease development in the graft. In this paper hence the active and passive biomechanical behaviours of the human saphenous vein and other venous walls were reviewed extensively and comprehensively. The existing in vitro uniaxial, bulge, planar and tubular biaxial tensile testing methods, in vivo testing cases, property variables, various tested results, constitutive models and their mathematical modelling methods, viscoelasticity, and residual strain/stress are highlighted and summarized. It is demonstrated that the biomechanical properties of the human saphenous vein and other venous walls are not well documented, and their modelling approaches are limited and subjected to be updated in a great deal. Additionally, a few important research issues are proposed. The paper has provided a piece of useful information to investigation into coronary artery bypass grafts.

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Pressure applied during surgery alters the biomechanical properties of human saphenous vein graft

Cited by 20 publications

References 35 publications

The no-touch saphenous vein for coronary artery bypass grafting maintains a patency, after 16 years, comparable to the left internal thoracic artery: A randomized trial

The no-touch saphenous vein for coronary artery bypass grafting maintains a patency, after 16 years, comparable to the left internal thoracic artery: A randomized trial

No-touch vein grafts and the destiny of venous revascularization in coronary artery bypass grafting—a 25th anniversary perspective

Biomechanical property and modelling of venous wall

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