UNIVERSITY-OF-WISCONSIN SOLUTION AND HUMAN SAPHENOUS-VEIN GRAFT PRESERVATION - PRELIMINARY ANATOMIC REPORT

Endothelial damage of human saphenous vein (HSV) during the preparatio n for bypass grafting could affect graft patency. Improving the preser vation of HSV could provide a longer and better patency of coronary ar tery bypass grafts. An electron microscopic comparative analysis of th e effects of three different preservatives on HSV morphology was carri ed on in order to determine the best method to prevent or minimize pos sible endothelial damage. Distal segments of HSVs were harvested from 15 patients with a ''no-touch'' technique. Each segment was divided in to seven specimens after a low pressure distension with saline solutio n. The first of them was fixed immediately after harvesting with 2.5% glutaraldehyde solution, for basal evaluation. Three were fixed after 30 min and three after 5 h preservation at 4-degrees-C in a) autologou s, oxygenated, and heparinized blood (AOHB), b) heparinized saline sol ution with papaverine (HSSP) and c) University of Wisconsin solution ( UWS). The specimens preserved in AOHB showed marked endothelial cell d etachment and endothelial cell loss after both preservation times (30 min and 5 h). The specimens preserved in HSSP for 30 min showed no alt eration in endothelium in 12 cases, while a partial endothelial detach ment with intracellular edema was present in the last 3 cases; all 5 h specimens showed only a few remnants of endothelial cells. The specim ens preserved in UWS for 30 min showed a morphology comparable to spec imens preserved in the saline solution for the same time; in the 5 h s pecimens a well preserved endothelium was found in 11 cases and partia l endothelial detachment and subendothelial edema in the other 4. Thes e data suggest blood solution as the least likely to preserve venous e ndothelium. Saline and Wisconsin solutions show analogous data after 3 0 minutes preservation, while UWS was better after 5 h.