Abstract
Introduction: Human saphenous vein (HSV) autografting into the coronary or peripheral arterial system is a widely practiced surgical approach. The primary mechanism of early graft failure is neointimal hyperplasia. Unfortunately, standard practice entails vein preservation in harmful solutions, notably, normal saline (NS). We hypothesized a balanced, euosmolar, pH-buffered solution would promote enhanced vasoreactivity, cellular viability and ultimately, improved patency. Methods: Unmanipulated samples of HSV tissue were obtained from patients undergoing CABG. Rings were cut and placed into University of Wisconsin (UW) solution, low-potassium UW, Celsior, PlasmaLyte (HP) and NS (all heparinized) for one hour, and hung on a muscle bath with unmanipulated control (UM). KCl-dependent contractility, as well as endothelial dependent (EDR) and independent (EIR) relaxation were assessed. Results: One-way ANOVA demonstrated KCl-induced contractility was reduced in NS-preserved HSV; significantly so relative to UW (n=9, p<0.05, Graph A). UW, low-potassium UW and Celsior produced a phenylephrine (PE)-induced contraction significantly greater than that seen in NS (n=9, p<0.05, Graph B), while UM, UW and HP vein show enhanced EDR relative to NS (n=11, p<0.05, Graph C). No EIDR differences were observed (n=7, Graph D). Conclusions: Using physiologic function to reflect graft viability, NS is toxic to HSV. KCl and PE-induced contractility, and EDR were all impaired. Thus, a buffered, balanced solution such as HP or UW is advocated for graft preservation.
Published Version
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