Introduction
Recent clinical data suggest intraoperative preservation of human saphenous vein (HSV)
in normal saline is associated with vein graft failure. We evaluated the influence
of several preservation media on acute physiologic function and cellular viability
of HSV conduit.
Methods
Unprepared (UP) HSV obtained from coronary artery bypass graft patients was characterized
on a muscle bath after 2-hour storage in 6 solutions: Plasma-Lyte A, 0.9% NaCl (normal
saline), University of Wisconsin solution, Celsior solution, autologous whole blood,
or glutathione-ascorbic acid L-arginine (GALA) solution. Vascular smooth muscle contractility
was assessed after exposure to depolarizing KCl and phenylephrine. The relaxation
of phenylephrine-precontracted HSV to sodium nitroprusside and carbachol (endothelial-independent
and -dependent relaxation, respectively) was also assessed. Cellular viability was
determined via the methyl thiazolyl tetrazolium (MTT) assay. Rat aortae were used
to assess the effect of pH during graft preservation on endothelial-dependent relaxation.
Results
Preservation of HSV in normal saline and autologous whole blood impaired contractile
responses to KCl relative to UP tissues, whereas preservation in University of Wisconsin
solution and Celsior solution enhanced contractile responses (P < .05). Relative to UP tissues, responses to phenylephrine were decreased with preservation
in normal saline, whereas preservation in University of Wisconsin solution, Celsior
solution, and GALA all potentiated these responses (P < .05). Only preservation in normal saline impaired endothelial-independent relaxation
(P = .005). Preservation in Plasma-Lyte A (P = .02), normal saline (P = .002), and University of Wisconsin solution (P = .02) impaired endothelial-dependent relaxation. Normal saline preservation decreased
MTT viability index relative to UP tissues (0.02 ± 0.002 mg−10.5 mL−1 vs 0.033 ± 0.005 mg−10.5 mL−1; P = .03). Endothelial function was impaired by acidic pH in rat aorta.
Conclusion
Preservation of HSV in normal saline causes graft injury leading to impaired physiologic
function and decreased viability of the HSV. This harm is mitigated by the use of
buffered salt solutions as preservation media.
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Article info
Publication history
Published online: May 20, 2015
Accepted:
March 18,
2015
Footnotes
Disclosures: Authors have no disclosures.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
