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冷心脏停搏液用于静脉移植物扩张和保存的研究:光镜和扫描电镜观察

Use of cold cardioplegic solution for vein graft distention and preservation: a light and scanning electron microscopic study.

作者信息

Kurusz M, Christman E W, Derrick J R, Tyers G F, Williams E H

出版信息

Ann Thorac Surg. 1981 Jul;32(1):68-74. doi: 10.1016/s0003-4975(10)61377-x.

Abstract

To evaluate the effect of a cardioplegic solution on the endothelium of the saphenous vein, portions of this vein were harvested from each of 5 patients undergoing coronary artery bypass operation. Each sample was divided into five segments. One segment was distended with heparinized saline solution, one with heparinized blood, and one with heparinized cardioplegic solution (25 mEq of potassium per liter). All of the distending solutions were kept at 10 degrees C, and pressure was carefully limited to 200 mm Hg. The fourth segment of vein was distended with heparinized saline solution but no effort was made to limit distending pressure, and the fifth segment was not distended. All samples were then examined with light and scanning electron microscopy. There were no great morphological differences in the endothelium of veins distended to 200 mm Hg with saline solution, blood, or cardioplegic solution. The morphology of these samples compared favorably with the control vein endothelium although scattered areas of endothelial disruption were present in every sample. Veins distended without pressure control showed massive endothelial disruption. The particular solution used to distend the sephenous veins is not as important as limiting the distending pressure.

摘要

为评估心脏停搏液对大隐静脉内皮的影响,从5例接受冠状动脉搭桥手术的患者身上分别采集部分大隐静脉。每个样本被分成五段。一段用肝素化盐溶液扩张,一段用肝素化血液扩张,一段用肝素化心脏停搏液(每升含25毫当量钾)扩张。所有扩张溶液均保持在10℃,压力小心地限制在200毫米汞柱。静脉的第四段用肝素化盐溶液扩张,但未采取措施限制扩张压力,第五段未扩张。然后对所有样本进行光镜和扫描电镜检查。用盐溶液、血液或心脏停搏液扩张至200毫米汞柱的静脉内皮在形态上没有很大差异。这些样本的形态与对照静脉内皮相比良好,尽管每个样本中都存在散在的内皮破坏区域。未控制压力而扩张的静脉显示出大量内皮破坏。用于扩张大隐静脉的特定溶液不如限制扩张压力重要。

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