Graft preservation solutions in cardiovascular surgery.

Winkler, Bernhard; Reineke, David Christian; Heinisch, Paul Philipp; Schönhoff, Florian; Huber, Christoph; Kadner, Alexander; Englberger, Lars; Carrel, Thierry (2016). Graft preservation solutions in cardiovascular surgery. Interactive cardiovascular and thoracic surgery, 23(2), ivw056. Oxford University Press 10.1093/icvts/ivw056

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Vein grafts are still the most commonly used graft material in cardiovascular surgery and much effort has been spent in recent years on investigating the optimal harvesting technique. One other related topic of similar importance remained more or less an incidental one. The storage solutions of vein grafts following procurement and prior to implantation are, despite their assumed impact, a relatively neglected theme. There is no doubt that the endothelium plays a key role in long-term patency of vein grafts, but the effects of the different storage solutions on the endothelium remain unclear : In a review of the literature, we could find 20 specific papers that addressed the question, of which the currently available preservation solutions are superior, harmless, damaging or ineffective. The focus lies on saline and autologous whole blood. Besides these two storage media, novel or alternative solutions have been investigated with surprising findings. In addition, a few words will be spent on potential alternatives and novel solutions on the market. As there is currently no randomized clinical trial regarding saline versus autologous whole blood available, this review compares all previous studies and methods of analysis to provide a certain level of evidence on this topic. In summary, saline has negative effects on the endothelial layers and therefore may compromise graft patency. Related factors, such as distension pressure, may outbalance the initial benefit of autologous whole blood or storage solutions and intensify the harmful effects of warm saline. In addition, there is no uniform consent on the superiority of autologous whole blood for vein graft storage. This may open the door to alternatives such as the University of Wisconsin solution or one of the specific designed storage solutions like TiProtec™ or Somaluthion™. Whether these preservation solutions are superior or advantageous remains the subject of further studies.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Winkler, Bernhard; Reineke, David Christian; Heinisch, Paul Philipp; Schönhoff, Florian; Huber, Christoph; Kadner, Alexander; Englberger, Lars and Carrel, Thierry

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1569-9293

Publisher:

Oxford University Press

Language:

English

Submitter:

Daniela Huber

Date Deposited:

30 Jun 2016 10:01

Last Modified:

21 Sep 2017 17:30

Publisher DOI:

10.1093/icvts/ivw056

PubMed ID:

27068248

Uncontrolled Keywords:

Coronary artery bypass surgery; Saphenous vein graft; Storage solutions

BORIS DOI:

10.7892/boris.81891

URI:

https://boris.unibe.ch/id/eprint/81891

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