Abstract
Long-term graft patency determines the prognosis of revascularization after coronary artery bypass grafting (CABG). Ischemia-reperfusion (I/R) injury of the graft suffered during harvesting and after implantation might influence graft patency. Aspirin, a nonsteroidal anti-inflammatory drug improves the long-term patency of vein grafts. Whether aspirin has the same effect on arterial grafts is questionable. We aimed to characterize the beneficial effects of aspirin on arterial bypass grafts in a rodent revascularization model. We gave Lewis rats oral pretreatment of either aspirin (n = 8) or saline (n = 8) for 5 days, then aortic arches were explanted and stored in cold preservation solution. The third group (n = 8) was a non-ischemia-reperfusion control. Afterwards the aortic arches were implanted into the abdominal aorta of recipient rats followed by 2 h of reperfusion. Endothelium-dependent vasorelaxation was examined with organ bath experiments. Immunohistochemical staining were carried out. Endothelium-dependent maximal vasorelaxation improved, nitro-oxidative stress and cell apoptosis decreased, and significant endothelial protection was shown in the aspirin preconditioned group, compared to the transplanted control group. Significantly improved endothelial function and reduced I/R injury induced structural damage were observed in free arterial grafts after oral administration of aspirin. Aspirin preconditioning before elective CABG might be beneficial on free arterial graft patency.
Highlights
Coronary artery bypass grafting (CABG) is the most durable treatment for coronary artery disease (CAD) [1]
Pretreatment with Acetylsalicylic acid (ASA) significantly improved the endothelium-dependent function of arterial rings when compared to the tCo group (p < 0.05) (Figure 2)
As endothelial function is one of term vascular graft patency after cardiac surgery [12], these findings provide new insights the major determinants of early- and late-term vascular graft patency after cardiac surgery in the endothelium protection of free arterial grafts, which could lead to improved patency rates of these type of grafts
Summary
Coronary artery bypass grafting (CABG) is the most durable treatment for coronary artery disease (CAD) [1]. Graft failure especially in the early postoperative period occurs in approximately 5–10% of patients with arterial grafts, and even more frequently in patients with vein grafts [2]. Focus was directed towards pre- and postoperative medications that could have the potential to improve graft patency and reduce cardiovascular events after CABG. The occlusion of bypass grafts within the first postoperative month is mostly due to thrombosis triggered by surgical trauma [2] and/or ischemia-reperfusion (I/R) injury induced endothelial dysfunction. Recent studies showed that the degree of I/R injury might be one of the major determinants among several factors influencing the long-term patency [3,4,5,6].
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