Cryopreserved Veins in Myocardial Revascularization: Possible Mechanism for Their Increased Failure Thomas V Bilfinger, MD, ScD, Alan R Hartman, MD,

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Presentation transcript:

Cryopreserved Veins in Myocardial Revascularization: Possible Mechanism for Their Increased Failure Thomas V Bilfinger, MD, ScD, Alan R Hartman, MD, Yu Liu, MD, Harold I Magazine, PhD, George B Stefano, PhD The Annals of Thoracic Surgery Volume 63, Issue 4, Pages 1063-1069 (April 1997) DOI: 10.1016/S0003-4975(97)00167-7

Fig. 1 Kaplan-Meier curve of event free survival with 95% confidence limits. Events are defined as death or recatheterization. The Annals of Thoracic Surgery 1997 63, 1063-1069DOI: (10.1016/S0003-4975(97)00167-7)

Fig. 2 Digital images of the saphenous vein coincubated with monocytes. (A) A control incubation with the monocytes adhering to the endothelial surface. The cells were stained with PKH26-GL. Bar = 50 μm for all images. (B) The endothelium exposed to 10−6 mol/L morphine is found to have fewer monocytes attached. (C) This preparation was coincubated with 10−6 mol/L morphine and 10−6 mol/L naloxone, resulting in greater adherence. (D) Coincubation with 10−6 mol/L morphine and 10−4 mol/L NG-nitro-l-arginine methyl ester, the nitric oxide synthase inhibitor resulted in greater adherence. The images were obtained by the Compix Image Analysis system (Mars, PA) and brought into Photostyler for positioning and final printing on a Tektronix Phaser 440 color printer. The Annals of Thoracic Surgery 1997 63, 1063-1069DOI: (10.1016/S0003-4975(97)00167-7)

Fig. 3 Morphine (Mor.) stimulation of nitric oxide (NO) release from human internal thoracic artery (Thor.) and saphenous vein (Saph.). After the addition of morphine (10−6 mol/L), nitric oxide is released from the saphenous vein and internal thoracic artery. (Inset) In cryopreserved vessels there is a lack of constitutive nitric oxide release upon morphine exposure. The 10-, 15-, and 20-minute values were compared with control levels: p < 0.001, p < 0.004, and p < 0.05, respectively. The Annals of Thoracic Surgery 1997 63, 1063-1069DOI: (10.1016/S0003-4975(97)00167-7)

Fig. 4 Digital images of the saphenous vein coincubated with monocytes. (A) A control vein not frozen or thawed. (B) A cryopreserved saphenous vein. In B we find large cellular clumping and areas completely devoid of cell adhering after morphine (10−6 mol/L) exposure. The Annals of Thoracic Surgery 1997 63, 1063-1069DOI: (10.1016/S0003-4975(97)00167-7)

Fig. 5 Representative contractile capacity of fresh and Cryolife-preserved saphenous veins: Human saphenous veins, fresh explants (solid line) or Cryolife-preserved veins (dashed line), were exposed to 100 mmol/L KCl and developed isometric tension was evaluated for approximately 10 minutes. Marked increases in contractile force were observed in fresh but not Cryolife-preserved veins, suggesting that the contractile capacity of Cryolife-preserved veins is markedly impaired. The Annals of Thoracic Surgery 1997 63, 1063-1069DOI: (10.1016/S0003-4975(97)00167-7)