HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Jamil G. Bashir Richard C. Cook Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Okon, E. B. Articles by van Breemen, C. Search for Related Content PubMed PubMed Citation Articles by Okon, E. B. Articles by van Breemen, C. Related Collections Coronary disease

Ann Thorac Surg 2004;77:108-114
© 2004 The Society of Thoracic Surgeons

---

Original article: cardiovascular

Effect of moderate pressure distention on the human saphenous vein vasomotor function

^a The iCAPTURE Centre, Department of Pathology and Laboratory Medicine, University of British Columbia and St. Paul Hospital, Vancouver, British Columbia, Canada
^b Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada

Accepted for publication June 5, 2003.

^* Address reprint requests to Dr Okon, iCAPTURE Centre, Rm 292, St. Paul's Hospital, 1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada
e-mail: eokon{at}mrl.ubc.ca

BACKGROUND: Manual pressure distension, which is commonly applied to the human saphenous vein graft for coronary artery bypass, is believed to have detrimental consequences for the graft patency. The vasomotor function of the vein after distention during surgical preparation for grafting and after distention in laboratory conditions at pressure of 50 to 600 mm Hg was studied. The effect of a combination of vasodilative agents to prevent vasospasm was also tested.

METHODS: The contractile and dilatory responses of distended and undistended human saphenous veins and those after drug treatment were examined in organ baths under isometric conditions.

RESULTS: Distention at the pressure range 100 to 300 mm Hg resulted in an increased contractile response of the saphenous vein to both -adrenergic activation with 50 µmol/L phenylephrine (153.73% ± 15.69%) and depolarization with 80 mmol/L K⁺ (141.03% ± 15.13%) in comparison with the undistended vein and did not impair the relaxation. In contrast manual distention during surgical preparation abolished the contractile response and impaired the relaxation. The application of a combination of vasodilative drugs (-adrenergic antagonist phenoxybenzamine, 10 µmol/L, Rho-kinase inhibitor HA-1077, 50 µmol/L, and calcium blocker nicardipine, 1 µmol/L) eliminated the contractile response of the vein to phenylephrine and 80 mmol/L K⁺. This effect was sustained more than 20 hours after the washout of the drugs.

CONCLUSIONS: The distention of the human saphenous vein at moderate pressure combined with the application of the effective combination of vasodilative drugs before grafting into the arterial circulation could be a beneficial alternative to the current practice of uncontrolled pressure distension.

This article has been cited by other articles:

				A. W.Y. Chung, P. Rauniyar, H. Luo, Y. N. Hsiang, C. van Breemen, and E. B. Okon Pharmacologic relaxation of vein grafts is beneficial compared with pressure distention caused by upregulation of endothelial nitric oxide synthase and nitric oxide production J. Thorac. Cardiovasc. Surg., October 1, 2006; 132(4): 925 - 932. [Abstract] [Full Text] [PDF]