AB076. SOH24AB_038. Endoscopic conduit harvest in coronary artery bypass graft surgery: a histological analysis of radial artery and saphenous vein grafts

Background: The aim of this study was to assess the effect of endoscopic harvest technique on vessel structural integrity, and to assess whether storing conduits in graft preservation solutions demonstrates any benefit in preservation of cellular integrity over heparinised saline.

Methods: This was a single-centre prospective observational study. Patients with coronary artery disease in whom coronary artery bypass grafting (CABG) was selected as the method of revascularisation, were asked to participate. Two tubular cuts ranging from 3–7 mm were taken from each conduit after ensuring sufficient remaining conduit length. One specimen was stored in heparinised saline and the other in DuraGraft for 60 minutes. Histological structure of the specimens was subsequently analysed using a series of specialised staining methods.

Results: There were 12 patients included in this pilot study. Eight of these underwent radial artery endoscopic harvesting. One sample was insufficient for examination. Of the 7 remaining, 6 underwent endoscopic harvest, with structural integrity of the radial artery remaining intact in 5 of these. One specimen showed disruption of the tunica media, with a preserved endothelial lining. No evidence of structural damage was seen in any of the 9 great saphenous vein specimens that were harvested endoscopically. No morphological differences were seen between vessels stored in DuraGraft or heparinised saline.

Conclusions: This pilot study did not demonstrate any histological damage in the conduits harvested endoscopically; that could be solely attributed to harvest technique, suggesting that this technique may be non-inferior to the traditional open technique of conduit harvest used in CABG.

Keywords: Coronary artery bypass grafting (CABG); coronary artery disease; endoscopic harvesting; great saphenous vein; radial artery