PRESSURE CONTROLLED PREPARATION OF THE SAPHENOUS-VEIN WITH PAPAVERINEFOR AORTOCORONARY VENOUS BYPASS

Background and Methods: In 21 patients intraoperatively receiving coro nary revascularization, segments of the saphenous vein were prepared f or aortocoronary bypass. Postoperatively, the endothelial intima was s ubjected to electron microscopy. Venous segments in which an intralumi nal mean pressure of 263 mmHg +/- 52 mmHg had been measured during pre paration were compared with venous segments that had been explanted wi th the aid of a venous protection bulldog and with pharmacological tre atment through papaverine, Results: Those segments of high-pressure di stension that had not been protected showed intimal damage with erythr ocytes and thrombocytes. On the other hand, venous segments with low-p ressure distension that had been protected in the described way during harvesting appeared similar to native veins. Conclusion: We conclude that during the preparation of the saphenous vein for aortocoronary by pass surgery, the application of papaverine and the use of the venous protection bulldog clamp is effective in preventing pressure damage du ring preparation of the vein.