Cryopreserved Veins in Myocardial Revascularization: Possible Mechanism for Their Increased Failure
Background. Cryopreserved veins are used as conduits for myocardial revascularization. However, a high failure rate associated with their use has been reported anecdotally. Methods. To find an explanation for the poor performance of cryopreserved vein grafts, we conducted a retrospective 5-year stud...
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Published in | The Annals of thoracic surgery Vol. 63; no. 4; pp. 1063 - 1069 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
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New York, NY
Elsevier Inc
01.04.1997
Elsevier Science |
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Abstract | Background. Cryopreserved veins are used as conduits for myocardial revascularization. However, a high failure rate associated with their use has been reported anecdotally.
Methods. To find an explanation for the poor performance of cryopreserved vein grafts, we conducted a retrospective 5-year study on all patients at a single institution in whom cryopreserved vein grafts were used. We further performed in vitro studies measuring cell adhesion, nitric oxide production, and contractile capacity of saphenous vein, internal thoracic artery, and cryopreserved veins.
Results. Forty-one patients were identified in whom one or more cryopreserved veins were used as a last resort. Sixteen had events (death or recatheterization). Seven deaths occurred (17%). Event-free survival was 50% at 12 months. Activated granulocyte/monocyte endothelial adherence could be lowered in internal thoracic arteries and saphenous veins with morphine incubation (50% and 57%, respectively), but not in cryopreserved veins. Simultaneous increases in nitric oxide release were also found in internal thoracic arteries and saphenous veins, but not cryopreserved veins. In addition, cryopreserved veins showed a diminished contractile capacity under experimental conditions.
Conclusions. In this highly select group of patients, cryopreserved veins had a high early failure rate, which may be partially due to the inability of the endothelium to participate in immunovascular processes.
(Ann Thorac Surg 1997;63:1063–9) |
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AbstractList | Cryopreserved veins are used as conduits for myocardial revascularization. However, a high failure rate associated with their use has been reported anecdotally.
To find an explanation for the poor performance of cryopreserved vein grafts, we conducted a retrospective 5-year study on all patients at a single institution in whom cryopreserved vein grafts were used. We further performed in vitro studies measuring cell adhesion, nitric oxide production, and contractile capacity of saphenous vein, internal thoracic artery, and cryopreserved veins. RESULTS; Forty-one patients were identified in whom one or more cryopreserved veins were used as a last resort. Sixteen had events (death or recatheterization). Seven deaths occurred (17%). Event-free survival was 50% at 12 months. Activated granulocyte/monocyte endothelial adherence could be lowered in internal thoracic arteries and saphenous veins with morphine incubation (50% and 57%, respectively), but not in cryopreserved veins. Simultaneous increases in nitric oxide release were also found in internal thoracic arteries and saphenous veins, but not cryopreserved veins. In addition, cryopreserved veins showed a diminished contractile capacity under experimental conditions.
In this highly select group of patients, cryopreserved veins had a high early failure rate, which may be partially due to the inability of the endothelium to participate in immunovascular processes. BACKGROUNDCryopreserved veins are used as conduits for myocardial revascularization. However, a high failure rate associated with their use has been reported anecdotally.METHODSTo find an explanation for the poor performance of cryopreserved vein grafts, we conducted a retrospective 5-year study on all patients at a single institution in whom cryopreserved vein grafts were used. We further performed in vitro studies measuring cell adhesion, nitric oxide production, and contractile capacity of saphenous vein, internal thoracic artery, and cryopreserved veins. RESULTS; Forty-one patients were identified in whom one or more cryopreserved veins were used as a last resort. Sixteen had events (death or recatheterization). Seven deaths occurred (17%). Event-free survival was 50% at 12 months. Activated granulocyte/monocyte endothelial adherence could be lowered in internal thoracic arteries and saphenous veins with morphine incubation (50% and 57%, respectively), but not in cryopreserved veins. Simultaneous increases in nitric oxide release were also found in internal thoracic arteries and saphenous veins, but not cryopreserved veins. In addition, cryopreserved veins showed a diminished contractile capacity under experimental conditions.CONCLUSIONSIn this highly select group of patients, cryopreserved veins had a high early failure rate, which may be partially due to the inability of the endothelium to participate in immunovascular processes. Background. Cryopreserved veins are used as conduits for myocardial revascularization. However, a high failure rate associated with their use has been reported anecdotally. Methods. To find an explanation for the poor performance of cryopreserved vein grafts, we conducted a retrospective 5-year study on all patients at a single institution in whom cryopreserved vein grafts were used. We further performed in vitro studies measuring cell adhesion, nitric oxide production, and contractile capacity of saphenous vein, internal thoracic artery, and cryopreserved veins. Results. Forty-one patients were identified in whom one or more cryopreserved veins were used as a last resort. Sixteen had events (death or recatheterization). Seven deaths occurred (17%). Event-free survival was 50% at 12 months. Activated granulocyte/monocyte endothelial adherence could be lowered in internal thoracic arteries and saphenous veins with morphine incubation (50% and 57%, respectively), but not in cryopreserved veins. Simultaneous increases in nitric oxide release were also found in internal thoracic arteries and saphenous veins, but not cryopreserved veins. In addition, cryopreserved veins showed a diminished contractile capacity under experimental conditions. Conclusions. In this highly select group of patients, cryopreserved veins had a high early failure rate, which may be partially due to the inability of the endothelium to participate in immunovascular processes. (Ann Thorac Surg 1997;63:1063–9) |
Author | Stefano, George B Magazine, Harold I Liu, Yu Hartman, Alan R Bilfinger, Thomas V |
Author_xml | – sequence: 1 givenname: Thomas V surname: Bilfinger fullname: Bilfinger, Thomas V organization: Division of Cardiothoracic Surgery, Cardiac Research Program, State University of New York at Stony Brook, Stony Brook, New York, USA – sequence: 2 givenname: Alan R surname: Hartman fullname: Hartman, Alan R organization: Division of Cardiothoracic Surgery, Cardiac Research Program, State University of New York at Stony Brook, Stony Brook, New York, USA – sequence: 3 givenname: Yu surname: Liu fullname: Liu, Yu organization: Division of Cardiothoracic Surgery, Cardiac Research Program, State University of New York at Stony Brook, Stony Brook, New York, USA – sequence: 4 givenname: Harold I surname: Magazine fullname: Magazine, Harold I organization: Division of Cardiothoracic Surgery, Cardiac Research Program, State University of New York at Stony Brook, Stony Brook, New York, USA – sequence: 5 givenname: George B surname: Stefano fullname: Stefano, George B organization: Division of Cardiothoracic Surgery, Cardiac Research Program, State University of New York at Stony Brook, Stony Brook, New York, USA |
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Keywords | endothelium nitric oxide internal thoracic artery cryopreserved veins morphine Human High risk Surgical revascularization Cardiovascular disease Coronary heart disease Statistical study Vascular disease Cryopreservation Etiology Surgery Myocardium Complication Graft Vein Failure |
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Snippet | Background. Cryopreserved veins are used as conduits for myocardial revascularization. However, a high failure rate associated with their use has been reported... Cryopreserved veins are used as conduits for myocardial revascularization. However, a high failure rate associated with their use has been reported... BACKGROUNDCryopreserved veins are used as conduits for myocardial revascularization. However, a high failure rate associated with their use has been reported... |
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SubjectTerms | Aged Biological and medical sciences Cell Adhesion - drug effects Cryopreservation cryopreserved veins endothelium Endothelium, Vascular - drug effects Endothelium, Vascular - metabolism Female Granulocytes - drug effects Humans internal thoracic artery Male Mammary Arteries - drug effects Medical sciences Monocytes - drug effects morphine Morphine - pharmacology Myocardial Revascularization - mortality Naloxone - pharmacology Narcotic Antagonists - pharmacology nitric oxide Nitric Oxide - metabolism Retrospective Studies Saphenous Vein - drug effects Superoxide Dismutase - pharmacology Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Transplantation, Homologous Treatment Failure |
Title | Cryopreserved Veins in Myocardial Revascularization: Possible Mechanism for Their Increased Failure |
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