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Pradeep Narayan
Mark Yeatman
Massimo Caputo
Radek Capoun
Franco Ciulli
Gianni D. Angelini
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J Thorac Cardiovasc Surg 2009;138:508-510
© 2009 The American Association for Thoracic Surgery

Brief Technique Report

Saphenous vein harvest with the Mayo extraluminal dissector: Is endothelial function preserved?

Pradeep Narayan, FRCS, Mark Yeatman, FRCS, Massimo Caputo, MD, Radek Capoun, MRCS, Franco Ciulli, FRCS, Jamie Y. Jeremy, PhD, Gianni D. Angelini, FRCS*

Bristol Heart Institute, Bristol Royal Infirmary, Bristol, United Kingdom

Received for publication March 5, 2008; revisions received March 28, 2008; accepted for publication April 20, 2008.

* Address for reprints: Gianni D. Angelini, FRCS, Bristol Heart Institute, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom. (Email: G.D.Angelini@bristol.ac.uk).

The first 20% of the full text of this article appears below.


   Introduction
 
Despite a significantly lower incidence of wound infection rates1Go and compelling evidence that there is no difference in the degree of preservation of histologic architecture, vascular tone, or vasomotor reactivity of veins harvested with the Mayo dissector (Johnson and Johnson, Langhorne, PA) and a similar graft patency compared with the open method,2Go use of the Mayo dissector still remains limited, probably because of a lack of evidence regarding the functional quality of the vein. In modern practice, although endoscopic vein harvest is gaining popularity, the Mayo dissector (Figure 1 ) still remains a satisfactory and inexpensive, albeit underused, alternative for vein harvesting, and hence we sought to examine the functional quality of the veins harvested with the Mayo extraluminal dissector.


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  		Figure 1. The Mayo extraluminal vein dissector.

 
Nitric oxide (NO), a vasoactive molecule produced from the endothelium, is a marker of endothelial function. NO is associated with a diminished incidence of neointimal proliferation, producing these effects through stimulation of soluble guanylate cyclase and generation of cyclic guanosine monophosphate (cGMP). To compare the functional ability of harvested saphenous veins with the Mayo stripper and conventional open dissection, we measured cGMP production ex vivo after stimulation with specific activators of the NO–cGMP axis.


   Clinical Summary
 
After obtaining informed consent, a consecutive series of 32 patients (25 male patients; age range, 46–80 years; median, 67 years) undergoing coronary artery bypass grafting were prospectively randomized into one of 2 groups to have their saphenous veins harvested either by means of conventional open dissection or with a Mayo dissector. This was carried . . . [Full Text of this Article]


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Saphenous vein harvest with the Mayo extraluminal dissector: Is endothelial function preserved?
Michael R. Dashwood, Stephen Fremes, and Domingos S.R. Souza
J. Thorac. Cardiovasc. Surg. 2010 139: 239-241. [Extract] [Full Text] [PDF]



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 J. Thorac. Cardiovasc. Surg.Home page
M. R. Dashwood, S. Fremes, and D. S.R. Souza
Saphenous vein harvest with the Mayo extraluminal dissector: Is endothelial function preserved?
J. Thorac. Cardiovasc. Surg., January 1, 2010; 139(1): 239 - 241.
[Full Text] [PDF]


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