Haymet A B, Pinto N, Peden S, Cohen T, Vallely M P, McGiffin D, Naidoo R, Jenkins J, Suen J Y, Fraser J F
Department of Vascular Surgery, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
Critical Care Research Group, The Prince Charles Hospital, Chermside, QLD, Australia.
Front Surg. 2022 Aug 26;9:956177. doi: 10.3389/fsurg.2022.956177. eCollection 2022.
During bypass surgery for peripheral arterial occlusive disease and ischaemic heart disease, autologous graft conduit including great saphenous veins and radial arteries are frequently stored in solution. Endothelial damage adversely affects the performance and patency of autologous bypass grafts, and intraoperative graft storage solutions have been shown to influence this process. The distribution of storage solutions currently used amongst Cardiothoracic and Vascular Surgeons from Australia and New Zealand is not well defined in the literature. The aim of this study was to determine current practices regarding autologous graft storage and handling amongst this cohort of surgeons, and discuss their potential relevance in the context of early graft failure. From this survey, the most frequently used storage solutions were heparinized saline for great saphenous veins, and pH-buffered solutions for radial arteries. Duration of storage was 30-45 min for almost half of respondents, although responses to this question were limited. Further research is required to investigate whether ischaemic endothelial injury generates a prothrombotic state, whether different storage media can alter this state, and whether this is directly associated with clinical outcomes of interest such as early graft failure.
在进行外周动脉闭塞性疾病和缺血性心脏病的搭桥手术时，包括大隐静脉和桡动脉在内的自体移植管道常被保存在溶液中。内皮损伤会对自体搭桥移植物的性能和通畅性产生不利影响，并且术中移植物保存溶液已被证明会影响这一过程。目前澳大利亚和新西兰心胸外科医生及血管外科医生使用的保存溶液的分布情况在文献中并未明确界定。本研究的目的是确定这组外科医生在自体移植物保存和处理方面的当前做法，并讨论它们在早期移植物失败背景下的潜在相关性。通过这项调查，最常用的保存溶液是用于大隐静脉的肝素化盐水和用于桡动脉的pH缓冲溶液。尽管对这个问题的回答有限，但几乎一半的受访者表示保存时间为30 - 45分钟。需要进一步研究来调查缺血性内皮损伤是否会产生促血栓形成状态，不同的保存介质是否能改变这种状态，以及这是否与诸如早期移植物失败等感兴趣的临床结果直接相关。
