Saphenous vein harvest with the Mayo extraluminal dissector: Is endothelial function preserved?

Abstract

Despite a significantly lower incidence of wound infection rates and compelling evidence that there is no difference in the degree of preservation of histologic architecture, vascular tone, or vasomotor reactivity of veins harvested with the Mayo dissector (Johnson and Johnson, Langhorne, PA) and a similar graft patency compared with the open method, use of the Mayo dissector still remains limited, probably because of a lack of evidence regarding the functional quality of the vein. In modern practice, although endoscopic vein harvest is gaining popularity, the Mayo dissector (Figure 1) still remains a satisfactory and inexpensive, albeit underused, alternative for vein harvesting, and hence we sought to examine the functional quality of the veins harvested with the Mayo extraluminal dissector. Nitric oxide (NO), a vasoactive molecule produced from the endothelium, is a marker of endothelial function. NO is associated with a diminished incidence of neointimal proliferation, producing these effects through stimulation of soluble guanylate cyclase and generation of cyclic guanosine monophosphate (cGMP). To compare the functional ability of harvested saphenous veins with the Mayo stripper and conventional open dissection, we measured cGMP production ex vivo after stimulation with specific activators of the NO–cGMP axis.