Toto Francesca, Torre Tiziano, Turchetto Lucia, Lo Cicero Viviana, Soncin Sabrina, Klersy Catherine, Demertzis Stefanos, Ferrari Enrico
Cardiac Surgery Unit, Cardiocentro Ticino Institute, 6900 Lugano, Switzerland.
Lugano Cell Factory, Cardiocentro Ticino Institute, 6900 Lugano, Switzerland.
J Clin Med. 2022 Feb 18;11(4):1093. doi: 10.3390/jcm11041093.
(1) Introduction: Intraoperative preservation solutions for saphenous vein grafts may influence the endothelial structure and increase the risk of graft failure after coronary surgery. The aim of the study was to compare the efficacy of three solutions in maintaining the endothelial cell integrity of venous segments. (2) Methods: We tested the efficacy of physiological saline solution (PSS), heparinized autologous blood (HAB) and DuraGraft in preserving the endothelium of vein segments by evaluating the degree of endothelial cell apoptosis. Two incubation times (2 and 4 h from harvesting) were used for each solution. The quantification of apoptotic cells was computed as the intensity nuclei/intensity area ratio. (3) Results: After 2 h of ischemia, the degree of apoptosis decreased progressively across the use of DuraGraft, HAB and PSS ( = 0.004), although only the difference between DuraGraft and PSS yielded a statistical significance ( = 0.002). After 4 h, a similar decrease in apoptosis was shown across the three media; however, statistical significance was not reached. The analysis of the elapsed time (2 or 4 h of incubation) showed that this was a relevant factor in maintaining the endothelial structural integrity independently from the storage solution (test for interaction of media and time = 0.010). (4) Conclusion: Within 2 h of incubation, endothelial structural integrity depended on the incubating medium. DuraGraft better protected the SVG against ischemic-induced apoptosis when compared to saline solution. Prolonged ischemia was associated with extended endothelium damage and none of the studied solutions protected the vein graft.
(1) 引言:用于隐静脉移植物的术中保存溶液可能会影响内皮结构,并增加冠状动脉手术后移植物失败的风险。本研究的目的是比较三种溶液在维持静脉段内皮细胞完整性方面的效果。(2) 方法:我们通过评估内皮细胞凋亡程度,测试了生理盐水溶液(PSS)、肝素化自体血(HAB)和DuraGraft在保存静脉段内皮方面的效果。每种溶液使用两个孵育时间(从采集后2小时和4小时)。凋亡细胞的定量计算为强度细胞核/强度面积比。(3) 结果:缺血2小时后,使用DuraGraft、HAB和PSS时凋亡程度逐渐降低(P = 0.004),尽管只有DuraGraft和PSS之间的差异具有统计学意义(P = 0.002)。4小时后,三种培养基中凋亡均有类似程度的降低;然而,未达到统计学意义。对孵育时间(2或4小时)的分析表明,这是一个独立于储存溶液维持内皮结构完整性的相关因素(培养基和时间的交互作用检验P = 0.010)。(4) 结论:在孵育2小时内,内皮结构完整性取决于孵育培养基。与盐溶液相比,DuraGraft能更好地保护SVG免受缺血诱导的凋亡。长时间缺血与内皮损伤扩大相关,且所研究的溶液均不能保护静脉移植物。