Improved Saphenous Vein Graft Patency in Coronary Artery Bypass Patients: The Contribution of an Intact Vasa Vasorum

摘要

The vasa vasorum supplies oxygen and nutrients to the wall of blood vessels and is more prolific in veins than in arteries. The patency of "no-touch" saphenous vein grafts, harvested complete with surrounding cushion of tissue, is comparable to the internal mammary artery in patients undergoing coronary artery bypass surgery (CABG). Here, vasa vasorum from paired segments of conventional and "no-touch" veins from patients undergoing CABG were identified and quantified by image analysis and their structure studied using electron microscopy. There were considerable ultrastructural alterations and a significant reduction in the number of vasa vasorum in conventional compared with "no-touch" harvested vein segments. We conclude that an intact vasa vasorum maintains blood supply to the wall of "no-touch" veins, contributing to the increased patency of grafts prepared using this technique.