Abstract
Introduction: Prolonging of the grafts permeability used in coronary bypass is a constant challenge. Objective: To compare anatomical and functional human saphenous veins (VSH) extracted “No touch” (NT) technique vs conventional technique (TC). Materials and Methods: Experimental study. VSH dissected with CT and NT in the Regional Hospital of Antofagasta cardiac surgery ward. VSH samples were sectioned into 3 mm rings and preserved in isolated organs chambers with Krebs-Ringer solution. To evaluate the vasomotor activity, norepinephrine (10-6M), papaverine (10-4M), acetylcholine (10-6M) and sodium nitroprusside (10-5M) was administered. A segment of samples was fixed in 10% formalin, processed and histological analyzed under light microscopy technique with hematoxylin-eosin, Verhoeff and orceina. Statistical analysis was performed using the Prism software Graphad. Results: Vascular Reactivity: norepinephrine-induced vasoconstriction was significantly higher in the group rings NT vs TC (p < 0.0001). Vasodilation was higher with papaverine and acetylcholine in the NT group (p < 0.004) and (p < 0.0003), respectively. Morphometric study: The NT group presented muscularis (0.755 vs 0.680 mm), adventitious (0.5600 vs 0.4663 mm), and total wall (1.344 vs 0.962 mm) thicker than the TC group. No significant differences in vasa vasorum number identified. Conclusion: The NT group vasoconstrictor and vasodilator responds significantly better. Results correlate with morphometric differences. Key words: saphenous vein; coronary artery bypass; pedicled ‘no-touch’; vascular damage.
Highlights
Prolonging of the grafts permeability used in coronary bypass is a constant challenge
Para buscar mejorías respecto a la vena safena se han utilizado arterias como la radial, epigástrica inferior, esplénica y subescapular, siendo la arteria mamaria interna el vaso de elección demostrando una permeabilidad de un 99%-100% a los 5 años en implante in situ[6]
No significant differences in vasa vasorum number identified
Summary
Prolonging of the grafts permeability used in coronary bypass is a constant challenge. Para buscar mejorías respecto a la vena safena se han utilizado arterias como la radial, epigástrica inferior, esplénica y subescapular, siendo la arteria mamaria interna el vaso de elección demostrando una permeabilidad de un 99%-100% a los 5 años en implante in situ[6]. Basado en antecedentes sobre las características funcionales del tejido adiposo perivascular, De Souza y colaboradores en 1996 describieron la técnica “no-touch” para extracción de la vena safena[2]. Los factores que podrían explicar la mejor funcionalidad del injerto serían el menor trauma mecánico y la acción protectora del tejido adiposo adyacente; como inconveniente se encuentra la extensión de la insición para extraer el injerto y las posibilidades de complicación de esta herida operatoria[2]. Nuestro objetivo fue comparar mediante la reactividad vascular in vitro y la histología de las venas safenas obtenidas con la técnica convencional y con la técnica “no-touch”
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