UNIVERSITY-OF-WISCONSIN SOLUTION AND HUMAN SAPHENOUS-VEIN GRAFT PRESERVATION - PRELIMINARY ANATOMIC REPORT
UNIVERSITY-OF-WISCONSIN SOLUTION AND HUMAN SAPHENOUS-VEIN GRAFT PRESERVATION - PRELIMINARY ANATOMIC REPORT
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DOI：
10.1016/1010-7940(93)90055-g
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发表时间：
1993-10-01
影响因子：
3.4
通讯作者：
SANTOLI, C
中科院分区：
文献类型：
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作者：
SANTOLI, E;DIMATTIA, D;SANTOLI, C
人大隐静脉(HSV)搭桥术准备过程中内皮细胞损伤会影响移植血管的通畅性。改善HSV的保存可以使冠状动脉搭桥术的通畅性更好、更持久。对三种不同防腐剂对HSV形态的影响进行了电子显微镜比较分析，以确定预防或减少可能的内皮损伤的最佳方法。取自15名患者的单纯疱疹病毒远端节段，采用“非接触”技术。每段标本经生理盐水低压扩张后分成7个标本。其中第一组在收获后立即用2.5%的戊二醛溶液固定，用于基础评价。A)自体含氧肝素化血液(AOHB)，b)含罂粟碱的肝素化生理盐水溶液(HSSP)，c)威斯康星大学溶液(UWS)。在AOHB中保存的标本在两种保存时间(30min和5h)后均可见明显的内皮细胞脱落和内皮细胞丢失。HSSP保存30min的标本，12例内皮细胞无变化，3例内皮细胞部分脱落，细胞内水肿，5h仅见少量内皮细胞残留。在UWS中保存30min的标本与在生理盐水中保存30min的标本的形态相似，5h的标本中有11例内皮保存良好，4例内皮部分脱落和内皮下水肿。这些数据表明，血液溶液保存静脉内皮的可能性最小。生理盐水和威斯康星溶液保存30min后数据相似，而UWS保存5h后数据更好。
Endothelial damage of human saphenous vein (HSV) during the preparation for bypass grafting could affect graft patency. Improving the preservation of HSV could provide a longer and better patency of coronary artery bypass grafts. An electron microscopic comparative analysis of the effects of three different preservatives on HSV morphology was carried on in order to determine the best method to prevent or minimize possible endothelial damage. Distal segments of HSVs were harvested from 15 patients with a ''no-touch'' technique. Each segment was divided into seven specimens after a low pressure distension with saline solution. The first of them was fixed immediately after harvesting with 2.5% glutaraldehyde solution, for basal evaluation. Three were fixed after 30 min and three after 5 h preservation at 4-degrees-C in a) autologous, oxygenated, and heparinized blood (AOHB), b) heparinized saline solution with papaverine (HSSP) and c) University of Wisconsin solution (UWS). The specimens preserved in AOHB showed marked endothelial cell detachment and endothelial cell loss after both preservation times (30 min and 5 h). The specimens preserved in HSSP for 30 min showed no alteration in endothelium in 12 cases, while a partial endothelial detachment with intracellular edema was present in the last 3 cases; all 5 h specimens showed only a few remnants of endothelial cells. The specimens preserved in UWS for 30 min showed a morphology comparable to specimens preserved in the saline solution for the same time; in the 5 h specimens a well preserved endothelium was found in 11 cases and partial endothelial detachment and subendothelial edema in the other 4. These data suggest blood solution as the least likely to preserve venous endothelium. Saline and Wisconsin solutions show analogous data after 30 minutes preservation, while UWS was better after 5 h.