Wise Eric S, Hocking Kyle M, Evans Brian C, Duvall Craig L, Cheung-Flynn Joyce, Brophy Colleen M
1 Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
2 Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland, USA.
Perfusion. 2017 Sep;32(6):489-494. doi: 10.1177/0267659117697814. Epub 2017 Mar 9.
Unregulated intraoperative distension of human saphenous vein (SV) graft leads to supraphysiologic luminal pressures and causes acute physiologic and cellular injury to the conduit. The effect of distension on tissue viscoelasticity, a biophysical property critical to a successful graft, is not well described. In this investigation, we quantify the loss of viscoelasticity in SV deformed by distension and compare the results to tissue distended in a pressure-controlled fashion.
Unmanipulated porcine SV was used as a control or distended without regulation and distended with an in-line pressure release valve (PRV). Rings were cut from these tissues and suspended on a muscle bath. Force versus time tracings of tissue constricted with KCl (110 mM) and relaxed with sodium nitroprusside (SNP) were fit to the Hill model of viscoelasticity, using mean absolute error (MAE) and r-goodness of fit as measures of conformity.
One-way ANOVA analysis demonstrated that, in tissue distended manually, the MAE was significantly greater and the r-goodness of fit was significantly lower than both undistended tissues and tissues distended with a PRV (p<0.05) in KCl-induced vasoconstriction and SNP-induced vasodilation.
Unregulated manual distension of SV graft causes loss of viscoelasticity and such loss may be mitigated with the use of an in-line PRV.
人体大隐静脉(SV)移植物在术中不受控制的扩张会导致管腔内压力超过生理水平,并对血管造成急性生理和细胞损伤。扩张对组织粘弹性(对成功的移植物至关重要的生物物理特性)的影响尚未得到充分描述。在本研究中,我们量化了因扩张而变形的SV中粘弹性的损失,并将结果与以压力控制方式扩张的组织进行比较。
未处理的猪SV用作对照,或无控制地扩张,并使用在线压力释放阀(PRV)进行扩张。从这些组织上切下环并悬挂在肌肉浴中。用氯化钾(110 mM)收缩并用硝普钠(SNP)舒张的组织的力-时间曲线拟合粘弹性的希尔模型,使用平均绝对误差(MAE)和拟合优度r作为符合度的度量。
单向方差分析表明,在手动扩张的组织中,在氯化钾诱导的血管收缩和硝普钠诱导的血管舒张中,MAE显著更大,拟合优度r显著低于未扩张组织和用PRV扩张的组织(p<0.05)。
SV移植物不受控制的手动扩张会导致粘弹性丧失,使用在线PRV可能会减轻这种损失。