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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
Saphenous vein conduits harvested by endoscopic technique exhibit structural and functional damage
Laki J Rousou1, Kristin B Taylor, Xiu-Gui Lu
1Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
The Annals of Thoracic Surgery
|December 23, 2008
Summary
Endoscopic saphenous vein harvest (ESVH) negatively impacts vein endothelial health compared to traditional open harvest (OSVH). This may reduce coronary artery bypass graft (CABG) success rates.
Area of Science:
- Vascular Surgery
- Cardiothoracic Surgery
- Biomedical Engineering
Background:
- Saphenous vein endothelial injury during harvest affects coronary artery bypass graft (CABG) surgery patency.
- Endoscopic saphenous vein harvest (ESVH) is increasingly used over traditional open saphenous vein harvest (OSVH).
Purpose of the Study:
- To compare the effects of ESVH and OSVH on saphenous vein endothelium structural and functional viability.
- To evaluate endothelial cell viability, calcium mobilization, and nitric oxide generation.
Main Methods:
- Prospective study of 10 CABG patients undergoing both ESVH and OSVH.
- Multiphoton imaging, immunofluorescence, and biochemical assays (Western blot) were used.
- Analysis included cell viability, calcium mobilization, nitric oxide, and protein distribution (caveolin, eNOS).
Main Results:
- OSVH showed significantly higher esterase activity, calcium mobilization, and nitric oxide production.
- ESVH group exhibited abnormal distribution of caveolin and endothelial nitric oxide synthase.
- p-values: p < 0.0001 for esterase activity and nitric oxide; p = 0.0209 for calcium mobilization.
Conclusions:
- ESVH demonstrates a detrimental effect on saphenous vein endothelium.
- This damage may lead to reduced graft patency and poorer patient outcomes in CABG surgery.
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