Introduction Recent clinical data suggest intraoperative preservation of human saphenous vein (HSV) in normal saline is associated with vein graft failure. We evaluated the influence of several preservation media on acute physiologic function and cellular viability of HSV conduit. Methods Unprepared (UP) HSV obtained from coronary artery bypass graft patients was characterized on a muscle bath after 2-hour storage in 6 solutions: Plasma-Lyte A, 0.9% NaCl (normal saline), University of Wisconsin solution, Celsior solution, autologous whole blood, or glutathione-ascorbic acid L-arginine (GALA) solution. Vascular smooth muscle contractility was assessed after exposure to depolarizing KCl and phenylephrine. The relaxation of phenylephrine-precontracted HSV to sodium nitroprusside and carbachol (endothelial-independent and -dependent relaxation, respectively) was also assessed. Cellular viability was determined via the methyl thiazolyl tetrazolium (MTT) assay. Rat aortae were used to assess the effect of pH during graft preservation on endothelial-dependent relaxation. Results Preservation of HSV in normal saline and autologous whole blood impaired contractile responses to KCl relative to UP tissues, whereas preservation in University of Wisconsin solution and Celsior solution enhanced contractile responses (P <.05). Relative to UP tissues, responses to phenylephrine were decreased with preservation in normal saline, whereas preservation in University of Wisconsin solution, Celsior solution, and GALA all potentiated these responses (P <.05). Only preservation in normal saline impaired endothelial-independent relaxation (P =.005). Preservation in Plasma-Lyte A (P =.02), normal saline (P =.002), and University of Wisconsin solution (P =.02) impaired endothelial-dependent relaxation. Normal saline preservation decreased MTT viability index relative to UP tissues (0.02 ± 0.002 mg-10.5 mL-1 vs 0.033 ± 0.005 mg-10.5 mL-1; P =.03). Endothelial function was impaired by acidic pH in rat aorta. Conclusion Preservation of HSV in normal saline causes graft injury leading to impaired physiologic function and decreased viability of the HSV. This harm is mitigated by the use of buffered salt solutions as preservation media.
Bibliographical noteFunding Information:
The authors thank the cardiac surgery attendings, physician assistants, and intraoperative nursing staff at Vanderbilt University and the Nashville VA for assistance in vein collection. This study was supported in part with resources and materials from the VA Tennessee Valley Healthcare System; NIH R01HL70715-09 and a Biomedical Laboratory Research and Development Grant to CB for design and conduct of the study, collection, management, analysis, and interpretation of the data, and drafting and approval of the manuscript; and NIH R01HL105731-01A1 to JC for design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, drafting and approval of the manuscript.