Publication: Human saphenous vein and coronary
bypass surgery: ultrastructural aspects of
conventional and “no-touch” vein graft preparations
Authors
Ahmed, S.R. ; Johansson, B.L. ; Karlsson, M.G. ; Souza, D.S.R. ; Dashwood, M.R. ; Loesch, A.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
Coronary artery bypass graft surgery
(CABG) is routinely used to restore blood flow to
diseased cardiac muscle due to coronary artery disease.
The patency of conventional grafts decreases with time,
which is due to thrombosis and formation of neointima.
A primary cause of graft failure is the mechanical
damage inflicted to the graft during harvesting, including
removal of surrounding tissue accompanied by high
pressure saline distension to overcome vasospasm (both
causing considerable mechanical trauma). The aim of
this study was to compare the ultrastructural features of
human saphenous vein (SV) grafts harvested
conventionally and grafts prepared using an atraumatic
‘no-touch’ harvesting technique introduced by Souza
(1996). The results of this study showed a better
preservation of the lumenal endothelium and medial
vascular smooth muscle (SM) in ‘no-touch’ versus
conventional grafts. A ‘fast’ (within 30 min) response of
SM cells to conventional harvesting was noted where
features of both SM cell division and apoptosis were
observed. It is concluded that the ‘preserved’ nature of
the ‘no-touch’ aortocoronary SV grafts renders them less
susceptible to thrombotic and atherosclerotic factors than
grafts harvested conventionally. These features are
suggested to contribute to the improved early patency
rate described using the no-touch technique of SV
harvesting.
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