995-22 The Effect of Perioperative Storage Solutions on the Long Term Vein Graft Function and Morphology

It has been shown that suboptimal preparation of a vein graft prior to its insertion results in immediate morphological and functional damage to the endothelial cells but not to the underlying smooth muscle cells. However. little is known if such perioperative injury to the vein grafts may influence the subsequent development of intimal hyperplasia and smooth muscle cell contractility. This study examines the influence of storage in saline or Ringer's lactate on the development of intimal hyperplasia and vasomotor function in experimental vein grafts. Twenty-six NM rabbits had a carotid vein bypass graft performed after the veins had been immersed (15 minutes) in either heparinized saline (Sal; n=13) or Ringer's lactate (RL; n=13) and each group was harvested after 28 days for either histology (n=8) or functional studies (n=5; four 5 mm rings/graft). Saline storage of the vein graft resulted in a 38% increase in the thickness of the intimal hyperplasia (113±2 vs. 83±μm, Sal vs. RL; mean±SEM, p<0.05) without a change in medial thickness (87±5 vs. 86±8μm, Sal vs. RL; p>0.05). There was no difference in the sensitivity to norepinephrine, serotonin and bradykinin between the two sets of vein grafts. The maximal contractile forces to serotonin and bradykinin were increased in the saline compared to Ringer's lactate stored vein grafts.SalineRinger'sp-valueNorepinephrine0.88±0.121.57±020<0.05Serotonin1.23±0.150.37±013<0.01Bradykinin2.08±0.110.52±007<0.01Values are the standardized maximal contractile force (maximal contraction/contraction to 60 mM KCI) expressed as mean±SEM.Saline storage of the vein graft results in the increased development of intimal hyperplasia with an overall enhanced contractility but without changes in agonist sensitivity. This study places further emphasis on the need for good perioperative care of the vein bypass graft because it results not only in the previously documented short term problems but also in long term structural and contractile changes which may contribute to decreased graft patency