Angelini G D, Breckenridge I M, Butchart E G, Armistead S H, Middleton K M, Henderson A H, Newby A C
Cardiovasc Res. 1985 Jun;19(6):326-34. doi: 10.1093/cvr/19.6.326.
Segments of saphenous vein from patients undergoing coronary artery by-pass graft surgery were frozen in liquid nitrogen immediately on dissection (control), after stripping of the adventitia and side branch ligation (manipulation), after distention with blood (distention), or at completion of the last proximal anastomosis (prepared vein). Vein was stored during the operation in patient's heparinised arterial blood at room temperature. Frozen vein was extracted with perchloric acid. ATP, ADP, and AMP, adenosine, inosine and hypoxanthine concentrations were measured by high pressure liquid chromatography. Prepared vein had ca 50% lower ATP concentrations and ATP/ADP ratio than control vein, higher concentrations of inosine and hypoxanthine and lower concentrations of AMP and adenosine. ATP concentration and ATP/ADP ratio did not correlate with the time elapsed between dissection and freezing of the prepared vein. The characteristic changes seen in prepared vein were not seen when control vein was simply stored in arterial blood at 23 degrees C, in normal saline at 23 degrees C or 4 degrees C, in Krebs-Ringer bicarbonate buffer at 37 degrees C or at St Thomas's Hospital cardioplegic solution at 4 degrees C. Distention with unlimited pressure did not distension at less than 300 mmHg gave rise to the same changes in ATP concentration and ATP/ADP ratio as in the prepared vein. These results show that vein suffered metabolic changes during preparation for bypass grafting and suggest that uncontrolled distention may contribute to these changes. Such biochemical measurements provide a quantitative estimate of tissue damage and allow objective comparison of different preparative techniques.
接受冠状动脉搭桥手术患者的大隐静脉段在解剖后立即（对照）、在剥除外膜和结扎侧支后（操作）、在用血液扩张后（扩张）或在完成最后一个近端吻合后（准备好的静脉），立即在液氮中冷冻。静脉在手术期间于室温下保存在患者的肝素化动脉血中。冷冻的静脉用高氯酸提取。通过高压液相色谱法测量ATP、ADP、AMP、腺苷、肌苷和次黄嘌呤的浓度。准备好的静脉的ATP浓度和ATP/ADP比值比对照静脉低约50%，肌苷和次黄嘌呤浓度较高，AMP和腺苷浓度较低。准备好的静脉的ATP浓度和ATP/ADP比值与解剖后至冷冻之间的时间间隔无关。当对照静脉简单地保存在23℃的动脉血中、23℃或4℃的生理盐水中、37℃的 Krebs-Ringer 碳酸氢盐缓冲液中或4℃的圣托马斯医院心脏停搏液中时，未观察到准备好的静脉中出现的特征性变化。以无限压力扩张（低于300 mmHg 时未扩张）会导致ATP浓度和ATP/ADP比值出现与准备好的静脉相同的变化。这些结果表明，静脉在用于搭桥移植的准备过程中发生了代谢变化，并表明不受控制的扩张可能导致这些变化。此类生化测量提供了组织损伤的定量估计，并允许对不同的制备技术进行客观比较。
