Original articleAdult cardiacHigh-Pressure Distention of the Saphenous Vein During Preparation Results in Increased Markers of Inflammation: A Potential Mechanism for Graft Failure
Section snippets
Patient Demographics
Saphenous vein samples were collected from 48 patients (39 men, 9 women) undergoing elective CABG. The procedures described herein were approved by the Institutional Review Boards of The University of Nebraska Medical Center and were carried out according to the principles outlined in the Declaration of Helsinki. All patients requiring 1- to 5-vessel bypasses using an SV graft were included (Table 1).
Intraoperative Saphenous Vein Harvest
Saphenous vein harvesting, as illustrated in Figure 1, was done by 2 physician assistants who
mRNA Levels in Distended Vein Segments
Reverse transcriptase–polymerase chain reaction (RT-PCR) was performed on all SV segments. Segment 0 received no distention and segment Last was located immediately adjacent to the tip of the vessel cannula. mRNA expression was compared across all segments. As seen in Figure 2A, a significant difference (p ≤ 0.05) in the expression of cell adhesion molecules was observed when comparing the nondistended segment (segment 0) to segments 1, 2, and Last. ICAM-1 was significantly upregulated when
Comment
Previous studies have looked at the increase in adhesion molecules after SV distention. However these studies examined immunohistochemical findings only and did not evaluate gene expression changes after vein preparation. This study set out to look at these and other markers of inflammation using RT-PCR in distended SV. This study is unique in that not only were nondistended veins compared with distended veins but also the intervening graft segments were investigated for mRNA expression
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