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J Thorac Cardiovasc Surg 1995;110:1381-1390
© 1995 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

INFLUENCE OF VEIN VALVES IN THE DEVELOPMENT OF ARTERIOSCLEROSIS IN VENOARTERIAL GRAFTS IN THE RABBIT

Los Angeles, Calif.

Address for reprints: Aurelio Chaux, MD, Co-Chairman, Department of Cardiothoracic Surgery, 8700 Beverly Blvd., Suite 6215, Los Angeles, CA 90048.

Abstract

Coronary saphenous vein grafts in human beings have a more limited long-term patency rate than internal thoracic artery grafts, primarily because of more rapid development of arteriosclerosis. The factors responsible for this increased susceptibility are not completely understood. To test the hypothesis that vein valves may influence this process, we studied 48 hypercholesterolemic rabbits with jugular vein grafts interposed into the carotid arterial circulation. In 24 animals (group A), the vein segments did not contain a vein valve. In the other 24 animals (group B), a vein valve was present. Both groups were further divided in four subgroups of six to be put to death at 2, 4, 6, and 8 weeks after the operation. All animals were fed a 2% cholesterol diet. At postmortem examination, alternate 2 mm sections were either stained with hematoxylin and eosin for histologic and morphometric studies or frozen in liquid nitrogen for immunohistochemistry and in situ hybridization studies. Proliferating cell nuclear antigen immunostaining was used to study cell proliferation. Wall thickness of vein grafts increased with time. During the first 2 weeks intimal and medial thickening was primarily due to an increase in numbers of cells. Between 2 and 6 weeks further intimal and medial thickening occurred, but without additional increase in cell numbers. After 6 weeks, foam cells and lipid deposits started to appear. By 8 weeks, changes identical to those seen in arteriosclerotic plaques in human beings were evident. These changes developed sooner and with more intensity in group B animals (p < 0.01 to 0.001), and they developed faster and with more severity in segments of vein located distal to the valve than in the segments located proximal to the valve (p < 0.001). This is the first controlled experiment demonstrating that the presence of valves in the vein segments is associated with augmented and accelerated intimal changes leading to vein atheromatosis. (J THORAC CARDIOVASC SURG 1995;110:1381-90)

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				D. Eguchi and Z. S. Katusic Inhibitory effect of valves on endothelium-dependent relaxations to calcium ionophore in canine saphenous vein Am J Physiol Heart Circ Physiol, February 1, 2001; 280(2): H892 - H898. [Abstract] [Full Text] [PDF]

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