J. Kuo et al., EFFECT OF VASCULAR CLAMP ON ENDOTHELIAL INTEGRITY OF THE INTERNAL MAMMARY ARTERY, The Annals of thoracic surgery, 55(4), 1993, pp. 923-926
The preservation of endothelial integrity is essential for maintaining
patency of vascular grafts. The internal mammary artery flow is often
interrupted with the application of a soft vascular clamp to achieve
a bloodless field during the anastomosis. We investigated the effect o
f the vascular clamp on the internal mammary artery endothelium using
the scanning electron and light microscope. The endothelium was examin
ed before and at 15 and 30 minutes after clamping in both the pedicled
and the skeletonized arteries. Endothelial integrity was breached by
damping with early evidence of platelet adhesion to the damaged areas.
The severity of the endothelial damage was related to the clamp time,
but there was no difference in the degree of damage between the pedic
led and the skeletonized arteries. We conclude that the vascular clamp
causes injury to the internal mammary artery endothelium and may be i
mplicated in early postoperative graft failure.