Comparison of vasospasm and vasodilatation response of saphenous vein grafts harvested by conventional and no-touch techniques

Amac: Calismamizda izole organ banyosu duzeneginde klasik teknik ve no-touch teknik ile hazirlanan safen ven greftlerinin (SVG) kasilma ve gevseme yanitlari karsilastirildi. Ca­lis­ma­pla­ni:­Subat 2007 Eylul 2007 tarihleri arasinda, bilgilendirilmis onam formu imzalatilarak, klinigimizde koroner arter baypas greft (KABG) cerrahisi yapilan 12 hasta (10 erkek, 2 kadin; ort. yas 55.6±5.8 yil; dagilim 38-75 yil) calismaya dahil edildi. Hazirlik asamasinda kullanilan teknikler goz onunde bulundurularak, greftler iki gruba ayrildi ve SGV’ler grup 1’de (n=16) klasik teknik, grup 2’de no-touch teknik ile hazirlandi. Grup 1’de SVG cevre yag dokulardan tamamen temizlenerek cikarildi. Grup 2’de SVG, safen siniri korunarak, cevresel yag doku ile birlikte cikarildi. Bul gu lar: No-touch teknikle hazirlanan SVG’lerde gevseme yanitlari anlamli derecede daha yuksek bulunurken, kasilma yanitlari acisindan klasik teknikle hazirlanan SVG’lerde dusuk dozlarda daha yuksek kasilma degerleri elde edildi. So­nuc:­Safen ven greftinin no-touch teknikle hazirlanarak kullanilmasinin greft yetmezlik oranlarinda azalma, ameliyat sonrasi morbidite ile mortalite oranlarinda azalma saglayabilecegi ve uzun donemde daha iyi greft acik kalma oranlarinin elde edilmesine yardimci olabilecegi kanisindayiz. Anah tar soz cuk ler: Koroner arter baypas greft; safen ven; vazospazm. Background:­ In this study, we aimed to compare vasoconstriction and vasodilatation responses of saphenous vein grafts (SVG) harvested by conventional and no touch techniques in tissue bath system. Methods: Between February 2007 and September 2007, 12 patients (10 males, 2 females; mean age 55.6±5.8 years; range 38 to 75 years) who underwent coronary artery bypass graft (CABG) surgery in our clinic with signed informed consents were included. Based on the techniques used during harvesting, the grafts were divided into two groups, including group 1 (n=16) with SVGs harvested by conventional technique and group 2 by no-touch technique. In group 1, SVG was removed completely from adjacent adipose tissues. In group 2, SVG was removed with adjacent adipose tissues, preserving saphenous nerves. Results:­ The vasodilatation response of SVGs was significantly higher with the no touch technique, while the vasoconstriction response of SVGs was significantly higher with the conventional technique at lower doses. Conclusion:­ We belive that no-touch harvesting technique of SVGs may decrease early graft failure and reduce also postoperative morbidity and mortality rate, contributing to improve graft patency rate in the long-term.