Specific Graft Treatment Solution Enhances Vascular Endothelial Function

² Department of Cardio-Vascular Surgery Vienna Heart Center Clinic Floridsdorf and Karl Landsteiner Institute for Cardio-Vascular Research, 1210 Vienna, Austria

^*Correspondence: bernhard.winkler@wienkav.at (Bernhard Winkler)
Academic Editors: Dragan M. Djuric and Teruo Inoue

Rev. Cardiovasc. Med. 2022, 23(11), 368; https://doi.org/10.31083/j.rcm2311368

Submitted: 7 July 2022 | Revised: 24 August 2022 | Accepted: 13 September 2022 | Published: 28 October 2022

(This article belongs to the Section Cardiovascular Intervention and Therapeutics)

This is an open access article under the CC BY 4.0 license.

Abstract

Background: Saline is still the most widely used storage and rinsing solution for vessel grafts during cardiac surgery despite knowing evidence of its negative influence on the human endothelial cell function. Aim of this study was to assess the effect of DuraGraft©, an intraoperative graft treatment solution, on human saphenous vein segments and further elaborate the vasoprotective effect on rat aortic segments in comparison to saline. Methods: Human Saphenous vein (HSV) graft segments from patients undergoing aortocoronary bypass surgery (n = 15), were randomized to DuraGraft© (n = 15) or saline (n = 15) solution before intraoperative storage. Each segment was divided into two subsegmental parts for evaluation. These segments as well as rat aortic segments stored in DuraGraft© underwent assessment of vascular function in a multichamber isometric myograph system in comparison to Krebs-Henseleit solution (KHS), a physiologic organ buffer solution. Results: Potassium-Chloride (KCL)-induced contraction depicted a tendency towards increase when treated with DuraGraft© compared to saline preservation of HSV segments (23.02 $\pm{}$ 14.77 vs 14.44 $\pm{}$ 9.13 mN, p = 0.0571). Vein segments preserved with DuraGraft© showed a significant improvement of endothelium-dependent vasorelaxation in response to cumulative concentrations of bradykinin compared to saline treated segments (p $<$ 0.05). Rat aortic segments stored in saline showed significantly impaired vasoconstriction (3.59 $\pm{}$ 4.20, p $<$ 0.0001) and vasorelaxation when compared to KHS and DuraGraft© (p $<$ 0.0001). Conclusions: DuraGraft© demonstrated a favorable effect on graft relaxation and contraction indicating preservation of vascular endothelial function. Clinical Trial Registration Number: NCT04614077.

Keywords

vein graft

preservation solution

endothelium

coronary artery bypass grafting

myograph

Funding

institutional funds and the Karl Landsteiner Society of Cardiac Research/ KH North Vienna

Figures

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Fig. 1.

Effect of preservation solution on contractile responses in HSV. (A) In response to the high K ${}^{+}$ (KCl) Krebs solution, the HSV segments showed tendency toward increase when stored in DuraGraft© compared to normal saline preservation (23.02 $\pm{}$ 14.77 vs 14.44 $\pm{}$ 9.13 mN, p = 0.0571). (B) In response to NE, HSV segments showed no difference between the storage conditions (Saline 85.31 $\pm{}$ 33.9% and DuraGraft© 72.66 $\pm{}$ 33.13%; p = 0.167). The NE response is expressed as percentage of KCl contraction. n = 15 patients and n = 23–25 segments/condition.

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Rev. Cardiovasc. Med. Print ISSN 1530-6550 Electronic ISSN 2153-8174