Retaining perivascular tissue of human saphenous vein grafts protects against surgical and distension-induced damage and preserves endothelial nitric oxide synthase and nitric oxide synthase activity
Retaining perivascular tissue of human saphenous vein grafts protects against surgical and distension-induced damage and preserves endothelial nitric oxide synthase and nitric oxide synthase activity
复制标题
DOI：
10.1016/j.jtcvs.2008.11.060
复制
发表时间：
2009-08-01
影响因子：
6
通讯作者：
Souza, Domingos S. R.
中科院分区：
文献类型：
--
作者：
Dashwood, Michael R.;Savage, Kay;Souza, Domingos S. R.
目的：用于冠状动脉搭桥手术的隐静脉的常规采集引起血管痉挛，其通过高压扩张来克服。通过“无接触”技术采集的隐静脉及其血管周围组织垫不会发生血管痉挛，也不需要扩张，从而改善了移植物的通畅性。本研究的目的是探讨手术损伤和高压扩张对内皮完整性和内皮型一氧化氮合酶的表达和活性在隐静脉收获和无血管周围tissue.Methods的影响：隐静脉从患者（n = 26）接受冠状动脉搭桥手术准备和无血管周围组织。我们分析了300 mm Hg扩张对形态学和内皮型一氧化氮合酶/一氧化氮合酶活性的影响，采用免疫组织化学、Western印迹分析、逆转录聚合酶链反应和酶测定相结合的方法。（有和无血管周围组织）与非扩张相比结果：扩张引起管腔内皮（通过CD 31染色评估）和血管壁的实质性损伤。内皮型一氧化氮合酶的表达和活性显着降低高压扩张和去除，或损坏，血管周围组织。扩张的效果显着小于那些与血管周围组织比那些没有血管周围组织在大多数cases.Conclusion：成功的隐静脉用作旁路移植术的影响，手术创伤和扩张。以最小损伤移除的静脉显示出增加的通畅率。我们表明，保留隐静脉血管周围组织准备冠状动脉搭桥手术的“无接触”技术保护扩张引起的损伤，保持血管形态，并保持内皮型一氧化氮合酶/一氧化氮合酶活性。
Objective: Conventional harvesting of saphenous vein used for coronary artery bypass surgery induces a vasospasm that is overcome by high-pressure distension. Saphenous vein harvested with its cushion of perivascular tissue by a "no touch'' technique does not undergo vasospasm and distension is not required, leading to an improved graft patency. The aim of this study is to investigate the effect of surgical damage and high-pressure distension on endothelial integrity and endothelial nitric oxide synthase expression and activity in saphenous vein harvested with and without perivascular tissue.Methods: Saphenous veins from patients (n = 26) undergoing coronary artery bypass surgery were prepared with and without perivascular tissue. We analyzed the effect of 300 mm Hg distension on morphology and endothelial nitric oxide synthase/nitric oxide synthase activity using a combination of immunohistochemistry, Western blot analysis, reverse transcriptase polymerase chain reaction, and enzyme assay in distended (with and without perivascular tissue) compared with nondistended (with and without perivascular tissue) segments.Results: Distension induced substantial damage to the luminal endothelium (assessed by CD31 staining) and vessel wall. Endothelial nitric oxide synthase expression and activity were significantly reduced by high-pressure distension and removal of, or damage to, perivascular tissue. The effect of distension was significantly less for those with perivascular tissue than for those without perivascular tissue in most cases.Conclusion: The success of the saphenous vein used as a bypass graft is affected by surgical trauma and distension. Veins removed with minimal damage exhibit increased patency rates. We show that retention of perivascular tissue on saphenous vein prepared for coronary artery bypass surgery by the "no touch'' technique protects against distension-induced damage, preserves vessel morphology, and maintains endothelial nitric oxide synthase/nitric oxide synthase activity.