Document Detail

Intracoronary shunt-induced endothelial cell damage in porcine heart.
MedLine Citation:
PMID:  16412472     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Injury to and dysfunction of the endothelium can compromise the patency of coronary arteries and lead to impaired perfusion of the heart. Such injury can occur after the application of an intravascular shunt and/or a snare to a coronary artery during bypass surgery. In this study, multiphoton microscopy was used to assess the integrity of endothelium in porcine coronary arteries subjected to shunting and snaring during off-pump coronary artery bypass grafting (OPCAB). MATERIALS AND METHODS: In open chest porcine, the left anterior descending artery was manipulated in different regions using snare and shunt to simulate OPCAB. Sections of left anterior descending artery were labeled with fluorescent dyes to evaluate the viability of the endothelium. The structural integrity of the endothelium was evaluated by calcein- and ethidium homodimer-mediated fluorescence. Endothelial functional viability was assessed by measuring cellular esterase activity, calcium mobilization, and endothelial nitric oxide synthase-mediated generation of nitric oxide using fluorescence dyes and multiphoton microscopy. RESULTS: Substantial endothelial damage was observed in shunted region of the coronary arteries. In contrast, endothelium remained structurally viable in regions that were snared, similar to control regions of the coronary arteries that were not manipulated. Esterase activity, calcium mobilization, and nitric oxide generation was greater in the control and snared regions of the coronary arteries in comparison to the shunted region. CONCLUSIONS: The use of intracoronary shunts led to structural damage and attenuation of endothelial function in porcine coronary arteries, whereas snared vessels maintained their viability and integrity, similar to the control sections. The routine use of shunts in OPCABG may lead to endothelial damage and possibly to long-term graft failure.
James H Dygert; Hemant S Thatte; Dharam J Kumbhani; Samer F Najjar; Patrick R Treanor; Shukri F Khuri
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2006-01-18
Journal Detail:
Title:  The Journal of surgical research     Volume:  131     ISSN:  0022-4804     ISO Abbreviation:  J. Surg. Res.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-03-14     Completed Date:  2006-04-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376340     Medline TA:  J Surg Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  168-74     Citation Subset:  IM    
Department of Surgery, VA Boston Healthcare System, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02132, USA.
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MeSH Terms
Anastomosis, Surgical
Coronary Artery Bypass, Off-Pump / adverse effects*,  methods
Coronary Vessels / pathology,  surgery
Endothelium / cytology,  pathology*
Ischemia / etiology
Suture Techniques

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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