Abstract
BackgroundCoronary occlusion techniques during OPCAB may lead to an endothelial damage to the target vessel. The adverse effects of these techniques are well-known, and researches have been trying to find out new materials to occlude the coronary artery without an endothelial damage. In the present study, we investigate to the endothelial damage in the rat aorta which is occluded by Poloxamer 407 gel.MethodsForty-five rats were randomized in three groups: (1) segment of the aorta was occluded with Poloxamer 407 gel in P 407 group; (2) segment of the aorta was occluded with microvascular clamp in MV clamp group; and (3) no onclusion was available in the Control group. The rats were sacrificed of observation, and a 15mm segment of the aorta was obtained as a specimen. Integrity of the endothelial lining was observed with a scanning electron microscopy.ResultsScanning electron microscopy revealed a statistically significant difference among the 3 groups (p<0,001) using the SPSS 13.0 test. No difference was found between the Control group and the P 407 group (p=0,059). The differences between MV clamp–Control group (p<0,001) and MV clamp–P 407 group were statistically significant (p<0,002).ConclusionsWe suggest that Poloxamer 407 gel occlusion may be a safer and more effective method compared to the microvascular clamp occlusion.
Highlights
Coronary occlusion techniques during OPCAB may lead to an endothelial damage to the target vessel
Coronary artery occlusion techniques during OPCAB often result in suboptimal visualization due to bleeding from arteriotomy site
Despite improvements in hemostatic devices used in OPCAB surgery, the perfect device which allows a complete control of bleeding without generating coronary endothelial injury is yet to be introduced for use
Summary
Coronary occlusion techniques during OPCAB may lead to an endothelial damage to the target vessel. Coronary artery occlusion techniques during OPCAB often result in suboptimal visualization due to bleeding from arteriotomy site This leads to an increase in surgical trauma and risk the quality of the anastomosis. Techniques and devices have been employed to improve the visibility during OPCAB surgery, including elastic snare sutures, microvascular clamps, intracoronary shunts and high flow gas insufflation materials. These techniques and devices all have a potential for mechanical damage to the coronary endothelium [1,2,3,4,5,6,7].
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