A new protective solution for hypothermic storage of free vein grafts in cardiovascular surgery
| Autor: | J. H. Brox, K. Bertheussen, L. Jørgensen, A. Småbrekke, Dag Sørlie, Steinar Solberg, Larsen T, Bjarne Østerud |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
medicine.medical_specialty
Endothelium Swine Potassium Clinical Biochemistry chemistry.chemical_element Vein graft Veins chemistry.chemical_compound medicine Animals Humans Incubation Cells Cultured HEPES business.industry General Medicine Poloxamer Surgery Cold Temperature Solutions Endothelial stem cell medicine.anatomical_structure chemistry Endothelium Vascular Tissue Preservation Mannitol business medicine.drug |
| Zdroj: | Scandinavian Journal of Clinical and Laboratory Investigation. 52:73-82 |
| ISSN: | 1502-7686 0036-5513 |
| Popis: | In order to reduce the operative injury of the endothelium in free reversed vein grafts, cultured human endothelial cells were used to test the optimal concentration of the constituents of a flushing solution for improved protection of the endothelium. The following solution proved to be the most suitable when tested at 20 degrees C; mannitol 160 mmol l-1, glucose 15 mmol l-1, NaCl 30 mmol l-1, KHCO3 5 mmol l-1, K2SO4 10 mmol l-1, KH2PO4 4 mmol l-1, MgSO4 20 mmol l-1, CaCl2 1.5 mmol l-1, potassium citrate 1.0 mmol l-1, Pluronic F-68 20 mg l-1, HEPES 4 mmol l-1, HEPES-Na 6 mmol l-1, pH 7.25, osmolality 325 mosmol kg-1 H2O. When endothelial cell injury was measured by a 51Cr-release assay, the new solution protected human endothelial cells in culture during hypothermic incubation better than isotonic NaCl, St Thomas' cardioplegic solution or Krebs-Henseleit's buffer. Transmission and scanning electron microscopy showed that the endothelium of human saphenous vein grafts was well preserved following 6 h of incubation at 20 degrees C with the new solution. As determined by morphometry using scanning electron microscopy, the endothelium of free porcine vein grafts was better preserved after incubation for 2 h at 20 degrees C with the new solution than with either isotonic NaCl (p = 0.02) or diluted, heparinized blood (p = 0.02) as the incubation medium, all cases observed following 2 h of subsequent arterial flow. The present study indicates that the endothelium of free vein grafts can be well protected against hypothermia when the flushing and irrigation fluid has a composition favouring endothelial protection. It appears likely that such treatment of vein grafts will reduce the frequency of vein graft narrowing and occlusion, post-operatively. |
| Databáze: | OpenAIRE |
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