Abstract

BackgroundIschemia–reperfusion injury of saphenous vein grafts (SVG) during coronary artery bypass grafting surgery negatively impacts endothelial integrity and functionality and is associated with vein graft failure. The aim of this study was to evaluate the level of oxidative stress in human SVG segments following ischemic storage in three intraoperative graft storage solutions: saline (S), autologous heparinized blood (HB) and DuraGraft (DG).Methods3 mm tissue rings derived from surplus SVG segments from 50 patients were stored at room temperature for 30 min in DG, S or HB. Total oxidative status (TOS) and total antioxidant status (TAS) levels were determined from which the oxidative stress index (OSI: TOS/TAS ratio) was calculated. A p-value < 0.017 was considered significant implementing a Bonferroni correction.ResultsTOS values were significantly lower for DG stored samples in comparison to both S and HB; there was no difference between S and HB (DG: 32.6 ± 1.8, S: 39.6 ± 2.8 and HB: 40.6 ± 2.4 µmol H2O2 eqv.; DG vs. S and DG vs. HB p < 0.0001, S vs. HB p = 0.047). TAS was higher for both DG and HB in comparison to S (DG: 8.9 ± 0.9, S: 6.9 ± 1.0 and HB: 8.6 ± 0.9 mmol Trolox eqv.; DG vs S p < 0.0001, DG vs. HB p = 0.263, S vs. HB p < 0.0001). OSI differed between all groups with the lowest value for DG (DG: 3.7 ± 0.2, S: 5.8 ± 0.4 and HB: 4.7 ± 0.2 µmol H2O2 eqv./mmol Trolox eqv.; all p < 0.0001).ConclusionsSaphenous veins grafts stored in DuraGraft had a lower oxidative level, higher antioxidant level and a lower oxidative stress index in comparison to saphenous vein grafts stored in saline or heparinized blood.ClinicalTrials.gov Identifier NCT02922088.

Highlights

  • Ischemia–reperfusion injury of saphenous vein grafts (SVG) during coronary artery bypass grafting surgery negatively impacts endothelial integrity and functionality and is associated with vein graft failure

  • SVG samples were obtained from 50 patients undergoing isolated or combined Coronary artery bypass graft (CABG) and valve surgery and either stored in DG (n = 50), S (n = 50) or heparinized blood (HB) (n = 50)

  • Biochemical analysis was performed for all SVG samples from all patients after storage in the respective solutions (Table 2 and Fig. 1)

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Summary

Introduction

Ischemia–reperfusion injury of saphenous vein grafts (SVG) during coronary artery bypass grafting surgery negatively impacts endothelial integrity and functionality and is associated with vein graft failure. Tekin et al Journal of Cardiothoracic Surgery (2022) 17:7 flushing), the primary mediator of intraoperative graft damage is ischemia–reperfusion injury (IRI) that occurs between graft harvesting and anastomosis [7]. Sufficient graft preservation that limits intraoperative IRI is a major determinant to maintain graft patency [8]. Since oxidative damage is mediated through the release of reactive oxygen species (ROS) and other oxidants from endothelial and other cells in the ischemic tissue, preservation solutions must have sufficient antioxidant activity to neutralize ROS in order to prevent oxidative damage

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