Comparison of convantional and no-touch technique in harvesting saphenous vein for coronary artery by-pass grafting in the view of endothelial damage

In this work, we studied patients who were diagnosed with ischemik heart disease and were expected to receive a coronary artery bypass graft operation. We compared the classical method and the no-touch method, both of which can be used to prevent endothelial damage during the preparation of the safen vein graft.Our subjects were 40 patients who were expected to receive a coronary artery bypass operation. These patients were not diagnosed with varis and venous deficiency and they had healthy vena safena magna (VSM). We seperated the patients into two groups; 20 patients had their veins prepared with the no-touch (group a) method and 20 patients had their veins prepared with the classical (group b) method. Samples were taken from both groups using VSM proximal region using the atraumatic procedure. Samples were divided into two and were prepared to be analyzed using light and electrone microscope. Intima, media, and adventitia regions of the samples were analyzed using light and electronie microscope. Safen veins that were prepared using the classical method were observed to have degraded vascular structure and advanced stages of endothelial degradation. Veins that were prepared using the no-touch method were observed to have preserved their vascularstructure and had minimal endothelial damage. Cell damage was categorized using the classification (grade 1, grade 2, grade 3, grade 4).Neither group's intima section had grade 2 or grade 3 cells. However, group a samples were homogenously grade 1 and group b's samples were homogenously grade 4. Statistically, there was a significant (p<0.001) difference between the groups in terms of grade 1 and grade 4 cells and vein intima was observed to degrade radically when the safen vein was prepared with the classical method.In conclusion, we observed that histomorphologic endothelium damage was significant when safen veins were prepared with the classical method, whereas preparing with the no-touch method led to less damage. In order to study the effects of this study to clinical work, one could conduct coronary angiography to patients in the future.Key words: Safen vein graft, mechanical distension, endotelial damage, coronary artery bypass graft