Венозные кондуиты в коронарной хирургии: старые проблемы - новые решения

Венозные кондуиты в коронарной хирургии: старые проблемы - новые решения

Автор: Вечерский Ю.Ю., Манвелян Д.В., Затолокин В.В., Шипулин В.М.

Журнал: Сибирский журнал клинической и экспериментальной медицины @cardiotomsk

Рубрика: Обзоры и лекции

Статья в выпуске: 1 т.34, 2019 года.

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Появление аутовенозного аортокоронарного шунтирования (АКШ) ознаменовало эпоху хирургической реваскуляризации у больных с ишемической болезнью сердца, что обеспечило эффективное лечение стенокардии и значительно улучшило долгосрочный прогноз. Венозные трансплантаты на сегодняшний день остаются наиболее востребованными кондуитами в коронарной хирургии в силу доступности, простоты выделения и отсутствия ограничений по длине. Несмотря на преимущества аутовенозного АКШ, главным недостатком является высокая частота дисфункции (недостаточности) венозных кондуитов, представляющая важную и нерешенную проблему в кардиологической и кардиохирургической практике. С другой стороны, традиционное выделение большой подкожной вены (БПВ) подразумевает рассечение мягких тканей на протяжении всей длины выделяемого кондуита и приводит к длительному стойкому болевому синдрому после операции, частым нарушениям кожной чувствительности и высокой частоте раневых осложнений со стороны нижних конечностей. Это удлиняет сроки реабилитации больных и ухудшает качество жизни. Существует подход выделения вены в блоке с окружающими тканями для оптимизации длительного функционирования венозного шунта, но данная методика еще более травматична по сравнению с традиционным методом, в связи с чем ее применение на практике ограничено. Появление минимально инвазивных методов выделения позволило сократить частоту раневых осложнений и улучшить косметический результат, однако нет убедительных данных об их влиянии на состоятельность шунтов в отдаленном периоде после операции. Проблемы использования венозных кондуитов при АКШ многогранны, а их решение необходимо для улучшения эффективности хирургической реваскуляризации.

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Коронарное шунтирование, недостаточность венозных шунтов, минимально инвазивная хирургия, эндоскопия, bridge-техника, наружное стентирование, гидравлическая дилатация венозных шунтов

Короткий адрес: https://sciup.org/149125274

IDR: 149125274   |   DOI: 10.29001/2073-8552-2019-34-1-24-32

Список литературы Венозные кондуиты в коронарной хирургии: старые проблемы - новые решения

  • Motwani J.G., Topol E.J. Aortocoronary saphenous vein graft disease: pathogenesis, predisposition, and prevention. Circulation. 1998 Mar. 10;97(9):916-931. Review.
  • Fitzgibbon G.M., Kafka H.P., Leach A.J., Keon W.J., Hooper G.D., Burton J.R. Coronary bypass graft fate and patient outcome: angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,388 patients during 25 years. J. Am. Coll. Cardiol. 1996 Sept.;28(3):616-626.
  • Cameron A.A., Davis K.B., Rogers W.J. Recurrence of angina after coronary artery bypass surgery: predictors and prognosis (CASS Registry). J. Am. Coll. Cardiol. 1995;4:895-899.
  • Roubos N., Rosenfeldt F.L., Richards S.M., Conyers R.A., Davis B.B. Improved preservation of saphenous vein grafts by the use of glyceryl trinitrate - verapamil solution during harvesting. Circulation. 1995;92 (suppl. II):II-31-II-36.
  • Verrier E.D., Boyle E.M. Jr. Endothelial cell injury in cardiovascular surgery. Ann. Thorac. Surg. 1996;62:915-922.
  • Angelini G.D., Christie M.I., Bryan A.J., Lewis M.J. Surgical preparation impairs release of endothelium-derived relaxing factor from human saphenous vein. Ann. Thorac. Surg. 1989;48:417-420.
  • Chesebro J.M., Fuster V. Platelet-inhibitor drugs before and after coronary artery bypass surgery and coronary angioplasty: the basis of their use, data from animal studies, clinical trial data, and current recommendations. Cardiology. 1986;73:292-305.
  • Dobrin P.B., Littoy F.N., Endean E.D. Mechanical factors predisposing to intimal hyperplasia and medial thickening in autogenous vein grafts. Surgery. 1989;105:393-400.
  • Walpola P.L., Gotlieb A.I., Cybulsky M.I., Langille B.L. Expression of ICAM-1 and VCAM-1 and monocyte adherence in arteries exposed to altered shear stress. Arterioscler. Thromb. Vasc. Biol. 1995;15:2-10.
  • Stark V.K., Hoch J.R., Warner T.F. Monocyte chemotactic protein-1 expression is associated with the development of vein graft intimal hyperplasia. Arterioscler. Thromb. Vasc. Biol. 1997;17:1614-1621.
  • Shuhaiber J.H., Evans A.N., Masssad M.G., Geha A.S. Mechanisms and future directions for prevention of vein graft failure in coronary bypass surgery. Eur. J. Cardiothorac. Surg. 2002;22:387-396.
  • Harskamp R.E., Lopes R.D., Baisden C.E., de Winter R.J., Alexander J.H. Saphenous vein graft failure after coronary artery bypass surgery: pathophysiology, management, and future directions. Ann. Surg. 2013;257(5):824-833.
  • DOI: 10.1097/SLA.0b013e318288c38d
  • Jeremy J.Y., Birkett S., Bryan A.J., Angelini G.D. Cyclic nucleotide synthesis by freshly isolated and surgically prepared human saphenous vein before and after 14 days culture. Eur. J. Vasc. Endovasc. Surg. 1997;13:72-78.
  • Muzaffar S., Shukla N., Angelini G.D., Jeremy J.Y. Hypoxia and the expression of gp91phox and endothelial nitric oxide synthase in the pulmonary artery. Thorax. 2005;60:305-313.
  • Jeremy J.Y., Shukla N., Muzaffar S., Handley A., Angelini G.D. Reactive oxygen species, vascular disease and cardiovascular surgery. Curr. Vasc. Pharmacol. 2004;2:229-236.
  • Lie J.T., Lawrie G.M., Morris G.C. Aortocoronary bypass saphenous vein graft atherosclerosis: anatomic study of 99 vein grafts from normal and hyperlipoproteinemic patients up to 75 months postoperatively. Am. J. Cardiol. 1977;40:906-914.
  • Вечерский Ю.Ю., Затолокин В.В., Петлин К.А., Шипулин В.М. Эндоскопическое выделение большой подкожной вены для коронарного шунтирования. Хирургия. Журнал им. Н.И. Пирогова. 2016;5:86-90.
  • DOI: 10.17116/hirurgia2016586-90
  • Raja S.G., Sarang Z. Endoscopic vein harvesting: technique, outcomes, concerns & controversies. J. Thorac. Dis. 2013 Nov.;5 (Suppl. 6):S630. Review.
  • DOI: 10.3978/j.issn.2072-1439.2013.10.01
  • Cheng D., Allen K., Cohn W., Connolly M., Edgerton J., Falk V., et al. Endoscopic vascular harvest in coronary artery bypass grafting surgery: a meta-analysis of randomized trials and controlled trials. Innovations (Phila). 2005;1(2):61-74.
  • Arnaoutakis D.J., Scully R.E., Sharma G., Shah S.K., Ozaki C.K., Belkin M., et al. Impact of body mass index and gender on wound complications after lower extremity arterial surgery. J. Vasc. Surg. 2017 Jun.;65(6):1713-1718.e1.
  • DOI: 10.1016/j.jvs.2016.12.116
  • Athanasiou T., Aziz O., Skapinakis P., Perunovic B., Hart J., Crossman M.C., Casula R. Leg wound infection after coronary artery bypass grafting: a meta-analysis comparing minimally invasive versus conventional vein harvesting. Ann. Thorac. Surg. 2003 Dec.;76(6):2141-2146.
  • Athanasiou T., Aziz O., Al-Ruzzeh S., Philippidis P., Jones C., Purkayastha S., et al. Are wound healing disturbances and length of hospital stay reduced with minimally invasive vein harvest? A meta-analysis. Eur. J. Cardiothorac. Surg. 2004 Nov.;26(5):1015-1026. Review.
  • Parsonnet V., Lari A.A., Shah I.H. New stent for support of veins in arterial grafts. Arch. Surg. 1963;87(4):696-702.
  • Jeremy J.Y., Gadsdon P., Shukla N., Vijayan V., Wyatt M., Newby A.C., et al. On the biology of saphenous vein grafts fitted with external synthetic sheaths and stents. Biomaterials. 2007 Feb.;28(6):895-908. Review.
  • Lee S.S., Cheng C.L., Yu D.S., Chang S.Y., Ma C.P. Vicryl mesh for repair of severely injured kidneys: an experimental study. J. Trauma. 1993; 34: 406-410.
  • Jeremy J.Y., Bulbulia R., Johnson J.L., Gadsdon P., Vijayan V., Shukla N., et al. A bioabsorbable (polyglactin) external sheath inhibits porcine saphenous vein graft thickening. J. Thorac. Cardiovasc. Surg. 2004;127:1766-1772.
  • Murphy G.J., Newby A.C., Jeremy J.Y., Baumbach A., Angelini G.D. A randomized trial of an external Dacron sheath for the prevention of vein graft disease: the Extent study. J. Thorac. Cardiovasc. Surg. 2007;134(2):504-505.
  • Schoettler J., Jussli-Melchers J., Grothusen C., Stracke L., Schoeneich F., Stohn S., et al. Highly flexible nitinol mesh to encase aortocoronary saphenous vein grafts: first clinical experiences and angiographic results nine months postoperatively. Interact. Cardiovasc. Thorac. Surg. 2011;13:396-400.
  • Taggart D.P., Gal Y.B., Lees B., Patel N., Webb C., Rehman S.M., et al. A randomized trial of external stenting for saphenous vein grafts in coronary artery bypass grafting. Ann. Thorac. Surg. 2015;99:2039-2045.
  • Souza D. A new no-touch preparation technique. Technical notes. Scand. J. Thorac. Cardiovasc. Surg. 1996;30:41-44.
  • Souza D.S., Christofferson R.H., Bomfim V., Filbey D. No-touch technique using saphenous vein harvested with its surrounding tissue for coronary artery bypass grafting maintains an intact endothelium. Scand. Cardiovasc. J. 1999;33:323-329.
  • Rueda F.D., Souza D., Lima R.D.C., Menezes A., Johansson B., Dashwood M., Vasconcelos F. Novel no-touch technique of harvesting the saphenous vein for coronary artery bypass grafting. Arq. Bras. Cardiol. 2008 Jun.;90(6):356-362. English, Portuguese.
  • Dashwood M.R., Dooley A., Shi-Wen X., Abraham D.J., Dreifaldt M., Souza D.S. Perivascular fat-derived leptin: a potential role in improved vein graft performance in coronary artery bypass surgery. Interact. Cardiovasc. Thorac. Surg. 2011;12:170-173.
  • Johansson B.L., Souza D.S., Bodin L., Filbey D., Loesch A., Geijer H., et al. Slower progression of atherosclerosis in vein grafts harvested with notouch technique compared with conventional harvesting technique in coronary artery bypass grafting: an angiographic and intravascular ultrasound study. Eur. J. Cardiothorac. Surg. 2010 Oct.;38(4):414-419.
  • DOI: 10.1016/j.ejcts.2010.02.007
  • Souza D.S., Dashwood M.R., Tsui J.C., Filbey D., Bodin L., Johansson B., et al. Improved patency in vein grafts harvested with surrounding tissue: results of a randomized study using three harvesting techniques. Ann. Thorac. Surg. 2002;73:1189-1195.
  • Samano N., Geijer H., Liden M., Fremes S., Bodin L., Souza D. The notouch saphenous vein for coronary artery bypass grafting maintains a patency, after 16 years, comparable to the left internal thoracic artery: a randomized trial. J. Thorac. Cardiovasc. Surg. 2015;150:880-888.
  • Dreifaldt M., Mannion J.D., Bodin L., Olsson H., Zagozdzon L., Souza D. The no-touch saphenous vein as the preferred second conduit for coronary artery bypass grafting. Ann. Thorac. Surg. 2013;96:105-111.
  • Galea J., Armstrong J., Francis S.E., Cooper G., Crossman D.C., Holt C.M. Alterations in c-fos expression, cell proliferation and apoptosis in pressure distended human saphenous vein. Cardiovasc. Res. 1999;44:436-448.
  • Gundry S.R., Jones M., Ishihara T., Ferrans V.J. Optimal preparation techniques for human saphenous vein grafts. Surgery. 1980 Dec.;88(6):785-794.
  • Chello M., Mastroroberto P., Frati G., Patt G., D’Ambrosio A., Di Sciascio G., et al. Pressure distension stimulates the expression of endothelial adhesion molecules in the human saphenous vein graft. Ann. Thorac. Surg. 2003 Aug.;76(2):453-458; discussion 458.
  • Okon E.B., Millar M.J., Crowley C.M., Bashir J.G., Cook R.C., Hsiang Y.N., et al. Effect of moderate pressure distention on the human saphenous vein vasomotor function. Ann. Thorac. Surg. 2004 Jan.;77(1):108-114; discussion 114-5.
  • Liu Z.G., Liu X.C., Yim A.P., He G.W. Direct measurement of nitric oxide release from saphenous vein: abolishment by surgical preparation. Ann. Thorac. Surg. 2001;71:133-137.
  • Angelini G.D., Bryan A.J., Williams H.M., Morgan R., Newby A.C. Distention promotes platelet and leukocyte adhesion and reduces short-term patency in pig arteriovenous bypass grafts. J. Thorac. Cardiovasc. Surg. 1990;99:433-439.
  • Holt C.M., Francis S.E., Newby A.C., Rogers S., Gadsdon P.A., Taylor T., et al. Comparison of response to injury in organ culture of human saphenous vein and internal mammary artery. Ann. Thorac. Surg. 1993;55:1522-1528.
  • Wilbring M., Ebner A., Schoenemann K., Knaut M., Tugtekin S.M., Zatschler B., et al. Heparinized blood better preserves cellular energy charge and vascular functions of intraoperatively stored saphenous vein grafts in comparison to isotonic sodium-chloride-solution. Clin. Hemorheol. Microcirc. 2013 Jan. 1;55(4):445-455.
  • DOI: 10.3233/CH131781
  • Woodward L.C., Antoniades C., Taggart D.P. Intraoperative Vein Graft Preservation: What Is the Solution? Ann. Thorac. Surg. 2016 Nov;102(5):1736-1746. Epub 2016 Sept. 10. Review.
  • DOI: 10.1016/j.athoracsur.2016.05.097
  • Wise E.S., Hocking K.M., Eagle S., Absi T., Komalavilas P., CheungFlynn J., et al. Preservation solution impacts physiologic function and cellular viability of human saphenous vein graft. Surgery. 2015 Aug.;158(2):537-546. Epub 2015 May 21.
  • DOI: 10.1016/j.surg.2015.03.036
  • Krishnamoorthy B., Critchley W.R., Glover A.T., Nair J., Jones M.T., Waterworth P.D., et al. A randomized study comparing three groups of vein harvesting methods for coronary artery bypass grafting: endoscopic harvest versus standard bridging and open techniques. Interact. Cardiovasc. Thorac. Surg. 2012;15(2):224-228.
  • DOI: 10.1093/icvts/ivs164
  • Jamison R.N., Ross M.J., Hoopman P., Griffin F., Levy J., Daly M., et al. Assessment of postoperative pain management: patient satisfaction and perceived helpfulness. Clin. J. Pain. 1997;13:229-236.
  • Cook R.C., Crowley C.M., Hayden R., Gao M., Fedoruk L., Lichtenstein S.V., et al. Traction injury during minimally invasive harvesting of the saphenous vein is associated with impaired endothelial function. J. Thorac. Cardiovasc. Surg. 2004 Jan.;127(1):65-71.
  • Elbassioni A.A.M., Amr M.A., Hassan H.S., Eldomiaty H.A. Bridging saphenous vein harvesting versus conventional techniques in patients undergoing coronary artery bypass grafting in Suez Canal university hospital. J. of the Egyptian Society of Cardio-Thoracic Surgery. 2017;25(3):210-216.
  • Lumsden A.B., Eaves F.F., Ofenloch J.C., Jordan W.D. Subcutaneous, video-assisted saphenous vein harvest: report of the first 30 cases. Cardiovasc. Surg. 1996;4(6):771-776.
  • Bitondo J.M., Daggett W.M., Torchiana D.F., Akins C.W., Hilgenberg A.D., Vlahakes G.J., et al. Endoscopic versus open saphenous vein harvest: a comparison of postoperative wound complications. Ann. Thorac. Surg. 2002 Feb.;73(2):523-528.
  • Allen K.B., Griffith G.L., Heimansohn D.A., Robison R.J., Matheny R.G., Schier J.J., et al. Endoscopic versus traditional saphenous vein harvesting: a prospective, randomized trial. Ann. Thorac. Surg. 1998 Jul.;66(1):26-31; discussion 31-2.
  • Allen K., Cheng D., Cohn W., Connolly M., Edgerton J., Falk V., et al. Endoscopic Vascular Harvest in Coronary Artery Bypass Grafting Surgery: A Consensus Statement of the International Society of Minimally Invasive Cardiothoracic Surgery (ISMICS) 2005. Innovations (Phila). 2005 Winter;1(2):51-60.
  • Lopes R.D., Hafley G.E., Allen K.B., Ferguson T.B., Peterson E.D., Harrington R.A., et al. Endoscopic versus open vein-graft harvesting in coronary-artery bypass surgery. N. Engl. J. Med. 2009;361:235-244.
  • Zenati M.A., Shroyer A.L., Collins J.F., Hattler B., Ota T., Almassi G.H., et al. Impact of endoscopic versus open saphenous vein harvest technique on late coronary artery bypass grafting patient outcomes in the ROOBY (Randomized On/Off Bypass) Trial. J. Thorac. Cardiovasc. Surg. 2011;141:338-344.
  • Sastry P., Rivinius R., Harvey R., Parker R.A., Rahm A.K., Thomas D., et al. The influence of endoscopic vein harvesting on outcomes after coronary bypass grafting: a meta-analysis of 267,525 patients. Eur. J. Cardiothorac. Surg. 2013 Dec.;44(6):980-989.
  • DOI: 10.1093/ejcts/ezt121
  • Hess C.N., Lopes R.D., Gibson C.M., Hager R., Wojdyla D.M., EnglumB.R., et al. Saphenous vein graft failure after coronary artery bypass surgery: insights from PREVENT IV. Circulation. 2014 Oct.;130(17):1445-1451.
  • DOI: 10.1161/CIRCULATIONAHA.113.008193
  • Desai P., Kiani S., Thiruvanthan N., Henkin S., Kurian D., Ziu P., et al. Impact of the learning curve for endoscopic vein harvest on conduit quality and early graft patency. Ann. Thorac. Surg. 2011May;91(5):1385- 1391; discussion 1391-1392.
  • DOI: 10.1016/j.athoracsur.2011.01.079
  • Lin T.Y., Chiu K.M., Wang M.J., Chu S.H. Carbon dioxide embolism during endoscopic saphenous vein harvesting in coronary artery bypass surgery. J. Thorac. Cardiovasc. Surg. 2003;126:2011-2015.
  • Suarez-Pierre A., Terasaki Y., Magruder J.T., Kapoor A., Grant M.C., Lawton J.S. Complications of CO2 insufflation during endoscopic vein harvesting. J. Card. Surg. 2017;32(12):783-789.
  • Rousou L.J., Taylor K.B., Lu X.G., Healey N., Crittenden M.D., Khuri S.F., et al. Saphenous Vein Conduits Harvested by Endoscopic Technique Exhibit Structural and Functional Damage. Ann. Thorac. Surg. 2009;87:62-70.
  • Brown E.N., Kon Z.N., Tran R., Burris N.S., Gu J., Laird P., et al. Strategies to reduce intraluminal clot formation in endoscopically harvested saphenous veins. J. Thorac. Cardiovasc. Surg. 2007 Nov.;134(5):1259- 1265. Epub 2007 Sept. 29.
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