The effect of different types of storage solutions on saphenous vein endothelial integrity in diabetic patients undergoing CABG

Abstract

Background/Aim. Taking in consideration the justified popularity of total arterial revascularization (TAR), the saphenous vein graft (SVG) is still one of the most utilized conduits in coronary artery bypass grafting (CABG). One of the determining factors of this conduit`s durability is its endothelial integrity at the time of surgery. The aim of the study was to investigate the effect of different storage solutions on SVG endothelial integrity in patients with diabetes mellitus (DM) type 2 and non-DM patients undergoing CABG. The solutions under evaluation were heparinized saline solution (0.9% NaCl), heparinized autologous whole blood, Bretschneider solution (HTK) and fresh frozen plasma solution (FFP). Methods. Forty patients were included in this study and were divided into two groups. Group A with 23 DM patients and group B with 17 non DM patients. The effects of these solutions were examined by immunohistochemical dyeing of CD34 antibodies and morphometric comparison in histologic samples of DM patients undergoing CABG between the 07.2021. and 09.2022. with samples provided by non-DM patients. Research was conducted in the facilities of the Cardiac Surgery Clinic, UCC Nis and the Department of Histology and Embryology Laboratory. Results. In this study the FFP solution showed the most prominent positive effect on preservation of Saphenous Venous Graft (SVG) endothelial integrity with the average cell integrity preservation of 92.20%. Bretschneider's solution was found to be the least effective with an endothelial cell preservation integrity of 26.77%. There was no marked no statistically significant difference in results from group A and B. Conclusion. There was a noticeable contrast in preserving SVG endothelial integrity between the two patient groups, type 2 DM and non-DM patients, although it was not statistically significant. The storage solution with the most beneficial effect on SVG endothelial integrity preservation was the FFP solution when harvested via conventional open method in CABG.