Effects of different techniques for human saphenous vein harvest during coronary artery bypass grafting on the integrity of the endothelium.
Project management at the University of Würzburg:
Though the number of arterial grafts is increasing, still in particular saphenous veins are used as bypass material in coronary artery bypass grafting. These veins, now connected to the arterial system, suffer from distinct histologic changes, like damage of the endothelium, necrosis, fibrosis of media and adventitia, fibrous thickening of the intima as well as fat deposits. A relatively high rate of restenosis is the consequence. The method of vein harvest seems to be initiating for the triggering of the trauma. Especially the initial damage of the endothelium and of the media of the veins during harvest and storage until implantation might be of particular importance.
Aim of the present study is to investigate the effect of different techniques for vein harvest on the integrity of the endothelium. In general, the saphenous veins are exposed after a longitudinal section of the skin, harvested and stored in the patient`s blood until connection to the heart. In the present study 3 other harvesting techniques are additionally investigated, which differ from each other only regarding the way of exposure (open surgically or endoscopically) and / or of storage (storage in heparinised blood or in situ or arterial perfusion). Small pieces of those veins are then investigated with conventional histopathology and the extent of damage of the endothelium is quantified by computer-based image-analysis as well as by functional tests.
Projekt period: from 12.2001 to 06.2003