Bilfinger T V, Hartman A R, Liu Y, Magazine H I, Stefano G B
Division of Cardiothoracic Surgery, Cardiac Research Program, State University of New York at Stony Brook, 11794-8191, USA.
Ann Thorac Surg. 1997 Apr;63(4):1063-9. doi: 10.1016/s0003-4975(97)00167-7.
Cryopreserved veins are used as conduits for myocardial revascularization. However, a high failure rate associated with their use has been reported anecdotally.
To find an explanation for the poor performance of cryopreserved vein grafts, we conducted a retrospective 5-year study on all patients at a single institution in whom cryopreserved vein grafts were used. We further performed in vitro studies measuring cell adhesion, nitric oxide production, and contractile capacity of saphenous vein, internal thoracic artery, and cryopreserved veins. RESULTS; Forty-one patients were identified in whom one or more cryopreserved veins were used as a last resort. Sixteen had events (death or recatheterization). Seven deaths occurred (17%). Event-free survival was 50% at 12 months. Activated granulocyte/monocyte endothelial adherence could be lowered in internal thoracic arteries and saphenous veins with morphine incubation (50% and 57%, respectively), but not in cryopreserved veins. Simultaneous increases in nitric oxide release were also found in internal thoracic arteries and saphenous veins, but not cryopreserved veins. In addition, cryopreserved veins showed a diminished contractile capacity under experimental conditions.
In this highly select group of patients, cryopreserved veins had a high early failure rate, which may be partially due to the inability of the endothelium to participate in immunovascular processes.
冷冻保存的静脉被用作心肌血运重建的管道。然而，有轶事报道称其使用失败率很高。
为了找出冷冻保存静脉移植物性能不佳的原因，我们对一家单一机构中所有使用冷冻保存静脉移植物的患者进行了一项为期5年的回顾性研究。我们还进行了体外研究，测量大隐静脉、胸廓内动脉和冷冻保存静脉的细胞黏附、一氧化氮生成和收缩能力。结果：确定了41例患者，他们将一条或多条冷冻保存静脉作为最后手段使用。16例发生事件（死亡或再次导管插入术）。7例死亡（17%）。12个月时无事件生存率为50%。吗啡孵育可降低胸廓内动脉和大隐静脉中活化粒细胞/单核细胞的内皮黏附（分别为50%和57%），但冷冻保存静脉中未降低。同时，胸廓内动脉和大隐静脉中一氧化氮释放也增加，但冷冻保存静脉中未增加。此外，在实验条件下，冷冻保存静脉的收缩能力降低。
在这一高度选择的患者群体中，冷冻保存静脉的早期失败率很高，这可能部分归因于内皮无法参与免疫血管过程。
