The Case for Endothelial Preservation via Pressure-Regulated Distension in the Preparation of Autologous Saphenous Vein Conduits in Cardiac and Peripheral Bypass Operations

Frontiers in Surgery

Eric S. Wise¹ 

关键词: vein graft preparation;    endothelium;    vascular;    saphenous vein graft;    CABG;    bypass;   

DOI  :  10.3389/fsurg.2016.00054

学科分类：外科医学

来源: Frontiers

【 摘 要 】

The human saphenous vein (HSV) remains the most common conduit for peripheral and aortocoronary bypass operations in the United States (1, 2), with ever improving, though suboptimal long-term patency rates. The mishandling of vein grafts during explantation, preparation, and autotransplantation is gaining attention as a source of injury portending increased short-term thrombosis as well as acceleration of neointimal formation, the most common cause of vein graft failure from 2 months to 2 years postoperatively (3, 4). The handling of vein grafts during the explantation has been thoughtfully addressed, as “no-touch” open harvest has emerged as an approach stressing a minimization of trauma to tissue handling. In “no-touch” harvesting, the graft is removed with a pedicle of surrounding tissue. This has been shown to maintain structural and functional integrity of all cell layers, prevent spasm (5), and improve graft patency (6, 7), while conferring protection from subsequent intraoperative manipulations (8, 9).

【 授权许可】

CC BY