Ann Thorac Surg 2004;77:1505
© 2004 The Society of Thoracic Surgeons
Correspondence
Preservation of saphenous vein endothelium
Aurelio Chaux, MD
Cardiothoracic Surgery, Saint Johns Hospital and Health Center, 1328 Twenty-Second St, Santa Monica, CA 90404, USA
e-mail: drchaux{at}cs.com
To the Editor:
I read with a great deal of interest the article by Thatte and colleagues [1]; their work is well presented and, in my view, very valuable. I congratulate them for two important contributions to the study of the fate of veins used as arterial grafts: (1) the use of multiphoton microscopy and specific fluorescent stains for calcium and nitric oxide metabolism and (2) the introduction of the newly formulated storage solution GALA (glutathione, ascorbic acid, L-arginine).
In 1998, my colleagues and I [2] published an article on perivascular delivery of NO using a polymer and an NO donor (spermine/NO) applied around a vein graft implanted in the arterial circulation of hypercholesterolemic rabbits. These experiments demonstrated a significant reduction in neointimal hyperplasia in the treated vein grafts as compared with those bathed in saline solution or polymer alone. We noted in our study that the major limitation of this method of NO delivery in humans would be due to technical difficulties in controlling the application of the polymer + spermine/NO mixture and the inflammatory reaction that it produces in the surrounding tissues. We called for research in other methods of delivery of NO. I hope that further testing of the GALA solution using animal models such as the one we described will demonstrate the beneficial effects of this very simple and readily available modality of delivery and that surgeons soon will be able to use it for the benefit of their patients.
References
- Thatte H.S., Biswas K.S., Najjar S.F., et al. Multi-photon microscopic evaluation of saphenous vein endothelium and its preservation with a new solution, GALA. Ann Thorac Surg 2003;75:1145-1152.[Abstract/Free Full Text]
- Chaux A., Ruan X.M., Fishbein M.C., et al. Perivascular delivery of a nitric oxide donor inhibits neointimal hyperplasia in vein grafts implanted in the arterial circulation. J Thorac Cardiovasc Surg 1998;115:604-614.[Abstract/Free Full Text]
