Saphenous Vein Conduits Harvested by Endoscopic Technique Exhibit Structural and Functional Damage
Saphenous Vein Conduits Harvested by Endoscopic Technique Exhibit Structural and Functional Damage
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DOI：
10.1016/j.athoracsur.2008.08.049
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发表时间：
2009-01-01
影响因子：
4.6
通讯作者：
Thatte, Hemant S.
中科院分区：
文献类型：
--
作者：
Rousou, Laki J.;Taylor, Kristin B.;Thatte, Hemant S.
背景。采集过程中隐静脉内皮损伤会影响冠状动脉搭桥手术后的通畅性。许多中心正在采用内镜下隐静脉采集（ESVH），而不是使用传统的开放式隐静脉采集（OSVH）技术。我们的目的是使用多光子成像、免疫荧光和生化技术来比较 ESVH 和 OSVH 对隐静脉内皮结构和功能活力的影响。方法。前瞻性地确定了 10 名计划进行冠状动脉搭桥手术的患者。每个人对隐静脉的一部分进行 ESVH，对另一部分进行 OSVH。每个部分的 1 厘米片段立即被运送到实验室进行处理。血管片段用荧光标记物标记，以量化细胞活力（酯酶活性）、钙动员和一氧化氮的产生。样品还用免疫荧光抗体标记，以可视化小窝蛋白、内皮一氧化氮合酶、冯维勒布兰德因子和钙粘蛋白，并使用蛋白质印迹技术提取以鉴定这些蛋白质。所有标记、成像和图像分析均以盲法完成。结果。 OSVH 组的酯酶活性显着较高 (p < 0.0001)。同样，OSVH 组的钙动员和一氧化氮生成显着更高（分别为 p = 0.0209，p < 0.0001）。免疫荧光和蛋白质印迹技术显示ESVH组中caveolin和内皮一氧化氮合酶的分布发生异常改变。结论。我们的研究表明，ESVH 对隐静脉内皮有不利影响，可能导致移植物通畅性下降和患者预后较差。
Background. Injury to the saphenous vein endothelium during harvest impacts patency after coronary artery bypass graft surgery. Many centers are adopting endoscopic saphenous vein harvest (ESVH) instead of using the traditional open saphenous vein harvest (OSVH) technique. Our objective was to compare the effects of ESVH and OSVH on the structural and functional viability of saphenous vein endothelium using multiphoton imaging, immunofluorescence, and biochemical techniques.Methods. Ten patients scheduled for coronary artery bypass graft surgery were prospectively identified. Each underwent ESVH for one portion and OSVH for another portion of the saphenous vein. A 1-cm segment from each portion was immediately transported to the laboratory for processing. The vessel segments were labeled with fluorescent markers to quantify cell viability (esterase activity), calcium mobilization, and generation of nitric oxide. Samples were also labeled with immunofluorescent antibodies to visualize caveolin, endothelial nitric oxide synthase, von Willebrand factor, and cadherin, and extracted to identify these proteins using Western blot techniques. All labeling, imaging, and image analysis was done in a blinded fashion.Results. Esterase activity was significantly higher in the OSVH group (p < 0.0001). Similarly, calcium mobilization and nitric oxide production were significantly greater in the OSVH group (p = 0.0209, p < 0.0001, respectively). Immunofluoresence and Western blot techniques demonstrated an abnormal alteration in distribution of caveolin and endothelial nitric oxide synthase in the ESVH group.Conclusions. Our study indicates that ESVH has a detrimental effect on the saphenous vein endothelium, which may lead to decreased graft patency and worse patient outcomes.