MORPHO-FUNCTIONAL CONDITION OF VENOUS CONDUITS AFTER ENDOSCOPIC HARVESTING

Abstract

Background. The morpho-functional integrity of the structures of the wall of the venous conduit during coronary artery bypass grafting is the guarantor of the functioning of autovenous bypass grafts in the long-term period. Allocating a vein in a flap with surrounding tissues ensures minimal effect on the vein with better results in the long-term, but it increases the risk of wound complications. Endoscopic vein harvesting contributes to a significant reduction in wound complications. However, according to literary data, this technique can negatively affect the bypass grafts passability due to the effects of mechanical manipulations and exposure to carbon dioxide. Previously, we developed a method for the endoscopic vein extraction in a flap with surrounding tissues that does not require carbon dioxide insufflation.Aim. The aim of the study was to assess the morphological and functional changes in the vein fragments harvested by the new original endoscopic method compared to the traditional open harvesting technique.Material and Methods. The fragments of the great saphenous vein were studied after endoscopic and open harvesting. From the access in the knee area, a 3–5 cm fragment of the vein was openly harvested and was then used for the biopsy in the control group. Next, the vein was harvested endoscopically and the fragments of this part of the vein comprised the study group. Light microscopy of the sections, stained with hematoxylin and eosin, was performed to assess the structural integrity of the venous walls; the expression of CD 31 and E-Cadherin was determined immunohistochemically to assess the viability and function of the endothelium.Results. The results of histological study suggested that the endothelium was more intact in the segments harvested endoscopically; moreover, immunohistochemistry data showed that the endothelium was more viable in these segments.