Pressure controlled preparation of the saphenous vein with papaverine for aortocoronary venous bypass.
METHODS
In 21 patients intraoperatively receiving coronary revascularization, segments of the saphenous vein were prepared for aortocoronary bypass. Postoperatively, the endothelial intima was subjected to electron microscopy. Venous segments in which an intraluminal mean pressure of 263 mmHg +/- 52 mmHg had been measured during preparation were compared with venous segments that had been explanted with the aid of a venous protection bulldog and with pharmacological treatment through papaverine.


RESULTS
Those segments of high-pressure distension that had not been protected showed intimal damage with erythrocytes and thrombocytes. On the other hand, venous segments with low-pressure distension that had been protected in the described way during harvesting appeared similar to native veins.


CONCLUSIONS
We conclude that during the preparation of the saphenous vein for aortocoronary bypass surgery, the application of papaverine and the use of the venous protection bulldog clamp is effective in preventing pressure damage during preparation of the vein.
Hausmann
H
H
Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Germany.
Merker
H J
HJ
Hetzer
R
R
D001792:Blood Platelets / Q000473:pathology; D003250:Constriction; D001026:Coronary Artery Bypass / Q000379:methods; D004730:Endothelium, Vascular / Q000187:drug effects / Q000473:pathology; D004912:Erythrocytes / Q000473:pathology; D006801:Humans; D007430:Intraoperative Care; D008854:Microscopy, Electron; D008855:Microscopy, Electron, Scanning; D010208:Papaverine / Q000627:therapeutic use*; D011312:Pressure / Q000009:adverse effects; D012501:Saphenous Vein / Q000187:drug effects / Q000473:pathology / Q000637:transplantation*; D013048:Specimen Handling; D017539:Tunica Intima / Q000187:drug effects / Q000473:pathology; D014656:Vascular Surgical Procedures / Q000295:instrumentation; D014665:Vasodilator Agents / Q000627:therapeutic use*
D014665:Vasodilator Agents; D010208:Papaverine