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The Journal of Thoracic and Cardiovascular Surgery, Vol 99, 433-439, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
GD Angelini, AJ Bryan, HM Williams, R Morgan and AC Newby
A pig model of autologous saphenous vein to common carotid artery bypass
grafting was developed. An end-to-end anastomotic technique led to lower
middle graft and distal turbulence. Saphenous veins were surgically
prepared with or without distention at 600 mm Hg, implanted into the
arterial circulation, and removed 2 hours later. Medial integrity was then
assessed by adenosine triphosphate/adenosine diphosphate concentration
ratio, and endothelial integrity, leukocyte and platelet adhesion by
scanning electron microscopy. In grafts made with undistended vein
adenosine triphosphate/adenosine diphosphate concentration ratio was not
significantly lower (3.0 +/- 0.1, n = 32) than in freshly isolated vein
(3.3 +/- 0.1, n = 26), endothelial cover was 98% +/- 1%, n = 6, and there
was little platelet or leukocyte adhesion. In distended grafts adenosine
triphosphate/adenosine diphosphate concentration ratio was reduced to 2.2
+/- 0.2 (n = 7, p less than 0.005), endothelial cover was reduced to 38%
+/- 14% (n = 6, p less than 0.001), and there was extensive platelet and
leukocyte adhesion to exposed subendothelium. In separate experiments graft
patency measured at 1 to 5 weeks was significantly greater (96%, n = 25)
when undistended vein was used than when distended vein was used (64%, n =
25, p less than 0.005). The data show that distention leads to medial and
endothelial damage and that this is associated with increased platelet and
leukocyte adhesion and with reduced early patency.
ARTICLES
Distention promotes platelet and leukocyte adhesion and reduces short- term patency in pig arteriovenous bypass grafts
Department of Cardiac Surgery, University Hospital of Wales, Heath Park, Cardiff, United Kingdom.
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E. Dregelid, K. Heldal, F. Resch, L. Stangeland, K. Breivik, and E. Svendsen Dilation of the internal mammary artery by external and intraluminal papaverine application J. Thorac. Cardiovasc. Surg., September 1, 1995; 110(3): 697 - 703. [Abstract] [Full Text]
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A. A. Soyombo, G. D. Angelini, and A. C. Newby Neointima formation is promoted by surgical preparation and inhibited by cyclic nucleotides in human saphenous vein organ cultures J. Thorac. Cardiovasc. Surg., January 1, 1995; 109(1): 2 - 12. [Abstract] [Full Text]
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S. E. Francis, S. Hunter, C. M. Holt, P. A. Gadsdon, S. Rogers, G. W. Duff, A. C. Newby, and G. D. Angelini Release of platelet-derived growth factor activity from pig venous arterial grafts J. Thorac. Cardiovasc. Surg., September 1, 1994; 108(3): 540 - 548. [Abstract] [Full Text]
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G. S. O'Neil, A. H. Chester, C. J. Schyns, S. Tadjkarimi, J. A. A. Borland, and M. H. Yacoub Effect of surgical preparation and arterialization on vasomotion of human saphenous vein J. Thorac. Cardiovasc. Surg., March 1, 1994; 107(3): 699 - 706. [Abstract] [Full Text]
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C. M. Holt, S. E. Francis, A. C. Newby, S. Rogers, P. A. Gadsdon, T. Taylor, and G. D. Angelini Comparison of response to injury in organ culture of human saphenous vein and internal mammary artery Ann. Thorac. Surg., June 1, 1993; 55(6): 1522 - 1528. [Abstract] [PDF]
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G.-W. He, F. L. Rosenfeldt, and J. A. Angus Pharmacological relaxation of the saphenous vein during harvesting for coronary artery bypass grafting Ann. Thorac. Surg., May 1, 1993; 55(5): 1210 - 1217. [Abstract] [PDF]
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A. G. Violaris, A. C. Newby, and G. D. Angelini Effects of external stenting on wall thickening in arteriovenous bypass grafts Ann. Thorac. Surg., March 1, 1993; 55(3): 667 - 671. [Abstract] [PDF]
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G. D. Angelini, A. J. Bryan, S. Hunter, and A. C. Newby A surgical technique that preserves human saphenous vein functional integrity Ann. Thorac. Surg., May 1, 1992; 53(5): 871 - 874. [Abstract] [PDF]
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