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血管周围纤维蛋白胶的应用对预防大隐静脉移植物内皮损伤有作用吗?一种实验模型。

Does perivascular fibrin glue application have a preventive effect for the endothelial damage on saphenous vein graft? An experimental model.

机构信息

Department of Cardiovasculary Surgery, Bursa City Hospital, Surgeon, Bursa.

Department of Pathology, Bursa City Hospital, Bursa.

出版信息

Cir Cir. 2023;91(2):212-217. doi: 10.24875/CIRU.22000142.

Abstract

BACKGROUND

The effect of tissue adhesives on coronary grafts in cardiac surgery is a controversial issue.

OBJECTIVE

The aim of this study is to investigate the effect of fibrin glue (FG) applied around the saphenous vein grafts (SVG) in preventing cellular damage resulting from intraluminal pressure increase.

METHODS

Twenty volunteer patients were included in this ex vivo study. The SVGs remained after coronary artery bypass grafting were connected to the arterial line of the cardiopulmonary bypass circuit. The grafts were divided into two segments and one segment received perivascular FG applied whereas the other part was used plain. SVGs were kept in circulation at 120 mmHg pressure 250 mL/min flow rate for 60 min. The tissues were sent for histopathological examination to determine the endothelial damage.

RESULTS

Endothelial damage was more pronounced in the control group when compared with the FG group. In the FG group, no damage was seen in 13 samples and no Type 3 endothelial damage was observe whereas Type 1 injury was detected in seven specimens, Type 2 injury was observed in seven specimens, and Type 3 injury was detected in two specimens in the control group.

CONCLUSION

Perivascular application of FG on the SVG showed a protective effect against endothelial damage resulting from increased intraluminal pressure.

摘要

背景

组织粘合剂在心脏手术中的冠状动脉移植物的效果是一个有争议的问题。

目的

本研究旨在探讨在预防静脉内压力升高导致的细胞损伤方面,在大隐静脉移植物(SVG)周围应用纤维蛋白胶(FG)的效果。

方法

这项离体研究纳入了 20 名志愿者患者。在冠状动脉旁路移植术后保留的 SVG 与体外循环回路的动脉线相连。将移植物分为两段,一段接受血管周围 FG 应用,而另一部分则为空白对照。将 SVGs 在 120mmHg 压力、250mL/min 流量下保持循环 60 分钟。将组织送去进行组织病理学检查,以确定内皮损伤。

结果

与 FG 组相比,对照组的内皮损伤更为明显。在 FG 组中,13 个样本未见损伤,未观察到 3 型内皮损伤,而在对照组中,7 个样本观察到 1 型损伤,7 个样本观察到 2 型损伤,2 个样本观察到 3 型损伤。

结论

在 SVG 周围应用 FG 显示出对静脉内压力升高导致的内皮损伤的保护作用。

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