Pathological differences of grafts adopt different harvesting methods for coronary artery bypass grafting

Abstract

Objective Compare effect of open vein harvest(OVH) and endoscopic vein harvest(EVH) on injury degree of vein wall by features of two methods of harvest of great saphenous veins. Methods Select OPCABG patients during September and December on 2014, using great saphenous vein as blood vessel bridge, total number of patients is 20. According to the different methods of venous harvest, 20 patients were divided into 2 groups: 10 patients for OVH and 10 patients for EVH. The harvested veins were in line with the conditions of blood vessel bridge. Clinical outcomes were observed: postoperative wound complications, and the evaluation results of great saphenous vein tissue injury. Great saphenous veins were paraffin embedded sections, 20 specimens of great saphenous vein from each group, hematoxylin and eosin-Iraq red, CD31, desmin, SMA, 4 kinds of staining methods stained were applied. Observe the saphenous vein intimal layer, elastic fiber layer, smooth muscle layer and outer membrane layer under the light microscope. Vascular injury was evaluated from the continuity, integrity and uniformity of the tissue, quantitative assessment results and statistical methods to analyze. Results The incidence of postoperative wound complications in EVH group was less than that of OVH group(P<0.05). There was no obvious difference on vascular injury of the saphenous vein intimal layer, elastic fiber layer, smooth muscle layer and outer membrane layer under the light microscope. Conclusion EVH method significantly reduces postoperative complications compared with OVH method. There is no significant difference on two kinds of vein harvest on vein injury degree. EVH is clinically feasible and safe. Key words: Goronary artery bypass; Thoracoscopy; Great saphenous veins