Endothelial function of human vena saphena magna prepared with different minimally invasive harvesting techniques.

OBJECTIVES

Minimally invasive saphenous harvesting techniques have been shown to reduce post-operative morbidity. However, when applying new techniques of vein harvesting, endothelial integrity should be preserved in order to guarantee graft quality. We investigated the impact of two different minimally invasive saphenous vein harvesting techniques on endothelial function compared with the traditional 'open' technique by inducing endothelium-dependent in vitro relaxation.

METHODS

Two different minimally invasive techniques for harvesting the greater saphenous vein were used in 66 patients, either using a video-assisted dissector (ETHI, n=33) or a light coupled retractor (AUTS, n=33); other patients were treated conventionally (CONV, n=30). The physiological response was tested in vitro using an organ chamber on vein segments exposed to acetylcholine after precontraction with potassium.

RESULTS

In both minimally invasive groups, two patients each had to be converted to the traditional open technique and dropped out of the study. The endothelial function of the other veins harvested by either of the minimally invasive techniques showed no significant difference compared with veins harvested conventionally. Reactivity was measured as the percentage relaxation of pharmacological contraction and was significant in all groups (P<0.05); ETHI, 49.1+/-4.2%; AUTS, 48.8+/-5.1%; and CONV, 51.7+/-6. 0%. The responder/non-responder ratio was similar in all groups: ETHI (two drop-outs), 28/3 (90.3%); AUTS (two drop-outs), 28/3 (90. 3%); and CONV, 27/3 (90.0%).

CONCLUSION

Veins harvested by minimally invasive techniques have not shown an impaired reactivity of the endothelium compared with the conventional technique.