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The Journal of Cardiovascular Surgery 1999 February;40(1):71-6

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Ultrastructural investigations for reducing endothelial cell damage of vein grafts during CABG-operation and practical consequences

Hickethier Th., Dammrich J., Silber R. E., Finster S., Elert O.

From the Department of Cardiovascular and Thoracic Surger, * Institute of Pathology University of Wuerzburg, Germany


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Back­ground. In the ­present ­study the influ­ence of dif­ferent ­storage solu­tions on endo­the­lial integ­rity or ­damage was inves­ti­gated ­with ­direct ­methods par­tic­u­larly ­with trans­mis­sion elec­tron micros­copy (TEM), scan­ning elec­tron micros­copy (SEM) and immu­no­his­to­chem­istry.
­Methods. Saph­e­nous ­vein seg­ments of 10 cm in ­length ­were ­taken sur­gi­cally ­from 6 ­male ­CABG- patients (­aged 60-70) ­under stan­dard­ized con­di­tions. ­Each ­vein seg­ment was cut ­into ­rings, ­which ­were incu­bated at ­room tem­per­a­ture for 45 min­utes in dif­ferent ­storage solu­tions, par­tic­u­larly in 0,9% ­sodium chlo­ride solu­tion and in buf­fered solu­tion (M 199) ­with 5% ­human ­serum ­albumin respec­tively. ­Then, the ­vein seg­ments ­were ­fixed in 3.5% glu­ta­ral­de­hyde and pre­pared for scan­ning and trans­mis­sion elec­tron micros­copy to eval­uate the endo­the­lial ­damage. In addi­tion, immu­no­his­to­chem­ical ­staining (CD34, ­PECAM and ­Factor ­VIII) was per­formed.
­Results. ­When ­using 0.9% ­sodium chlo­ride solu­tion, the SEM-exam­ina­tion ­revealed ­that 55% of the ­cell pop­u­la­tion was ­destroyed. In com­par­ison to ­these find­ings ­only 26% of the endo­the­lial ­cell pop­u­la­tion was dam­aged ­when the ­venous seg­ment was ­stored in buf­fered solu­tion ­with 5% ­albumin (p<0.01). In immu­no­his­to­chem­istry (CD34, ­PECAM, ­Factor ­VIII) ­these find­ings ­were sup­ported.
Con­clu­sions. ­This ­study dem­on­strates the impor­tance of ­storage solu­tions in ­regard to endo­the­lial integ­rity. For ­best pres­er­va­tion of endo­the­lium it is nec­es­sary to ­modify con­ven­tional ­storage ­methods. So, ­storage in buf­fered solu­tion ­with ­albumin has ­shown ­much ­better endo­the­lial ­cell pres­er­va­tion com­pared ­with phys­io­log­ical ­saline ­which ­might ­reduce the oblit­er­a­tion ­rate of ­CABG in ­future.

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