A Comparative Study Of Different Distention Solutions And Their Preservation On Greater Saphenous Vein Endothelial Cells During CABG Surgery

Objective: To compare different distention solutions and their preservation effects on endothelial cells of greater saphenous vein (GSV). Methods: Consecutive ninety patients with isolated coronary artery bypass grafting (CABG) were enrolled into three groups randomly: the Glyceryl Trinitrate-Verapamil group (GV group, N=32), Papaverine group (Pap group, N=28) and control group (N=30). The harvested greater saphenous veins were routinely distended, and the distention solution of each group was different. The peak distention pressure during distention, the numbers of dead vascular endothelial cells (VECs) per unit area and the dose of nitric oxide (NO) synthesized and released per unit area after distention were measured. Results: The dead VECs and even the laceration of vascular smooth muscle cells (VSMCs) in the tunica media of all three groups were noted after distention. But the peak distention pressure in GV group was lower than that in the Pap and control group (P <0.05), the numbers of dead vascular endothelial cells per unit area in the GV group was remarkably fewer than that in the Pap and control group (P <0.05), while the dose of NO synthesized and released in per unit area was much higher than that in the Pap and controlgroup (P <0.05). Conclusions: 1. Distention after GSV harvesting is a trauma process on VECs. 2. GV distention solution can remarkbly reduce the pressure which can meet the needs of expansion in GSV, and can maximally preserve the VEC and the integrality of the vascular endothelium, which can theoretically improve the long patency of the GSV graft.