Ann Thorac Surg 2001;72:S2252
© 2001 The Society of Thoracic Surgeons
Supplement: Monitoring and improving patient safety during and following cardiac surgery
Discussion
Frank W. Sellke, MDa
a Division of Cardiothoracic Surgery, Beth Israel-Deaconess Medical Center, Harvard Medical School, 110 Francis Street, #LMOB Suite 2A, Boston, MA 02215, USA
e-mail: fsellke@caregroup.harvard.edu
I would like to congratulate Drs Thatte and Khuri on a very nice presentation. Their paper and presentation nicely describe the influence of endothelial cell viability and function on graft patency. Although there is little evidence that suggests that endothelial injury has much to do with short-term patency of grafts provided the anastomoses is technically sound and of sufficient caliber, there is significant evidence that, within several weeks postoperatively, the health of the vascular tissue (particularly the endothelium) can have a dramatic effect on the patency of bypass grafts. This is due, of course, to the production of nitric oxide, prostacyclin, and other endothelially derived vasodilators, and also to the inhibitory effect by these substances on platelet and neutrophil aggregation. These substances may have a dramatic effect on long-term patency.
I have several comments regarding the paper. First, a minor point. It was stated that adenosine was released from the endothelial cells. The vast majority of adenosine is released from the vascular smooth muscle and, . . . [Full Text of this Article]
Copyright © 2001 by The Society of Thoracic Surgeons.
