Molecular differences between arterial and venous grafts in the first year after coronary artery bypass grafting
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ORIGINAL PAPER
Molecular differences between arterial and venous grafts in the first year after coronary artery bypass grafting Christina Maria Steger1 · Arndt Hartmann2 · Ralf Joachim Rieker2 Accepted: 16 June 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Despite commonly used for coronary artery bypass surgery, saphenous vein (SV) grafts have significantly lower patency rates in comparison to internal thoracic artery (ITA) grafts, which might be due to the structural characteristics of the vessel wall but also due to differences in oxidative stress adaptation and molecular signaling and regulation. This human post mortem study included a total of 150 human bypass grafts (75 SV grafts and 75 ITA grafts) obtained from 60 patients divided into five groups due to the time period of implantation: group 1: baseline group without grafting; group 2: 1 day; group 3: > 1 day–1 week; group 4: > 1 week–1 month; group 5: > 1 month–1 year. Pieces of 3 mm length were fixed with formaldehyde, dehydrated, wax embedded, cut into sections of 3 µm thickness, and histologically and immunohistochemically examined. Over the whole time period, we observed a lower neointima formation and a better preserved media in ITA grafts with a higher percentage of TNF-α, PDGFR-α, and VEGF-A in nearly all vessel wall layers, a higher amount of MMP-7, MMP-9, EGFR, and bFGF positive cells in SV grafts and a timely different peak not only between ITA and SV grafts but also within the various vessel wall layers of both graft types. Since most of the examined growth factors, growth factor receptors and cytokines are regulated by MAPKs, our results suggest an activation of different pathways in both vessel graft types immediately after bypass grafting. Keywords Coronary artery bypass grafting · SV graft · ITA graft · Growth factors · MAPK
Introduction Coronary artery bypass grafting (CABG) for the treatment of ischemic heart disease is one of the most frequently performed surgical procedures worldwide, and due to the technical advantages the saphenous vein (SV) is still the most used conduit, although long-term studies confirm that internal thoracic artery (ITA) grafts have a higher patency and better outcome than saphenous veins. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00418-020-01896-4) contains supplementary material, which is available to authorized users. * Christina Maria Steger [email protected] 1
Department of Pathology, Academic Teaching Hospital Feldkirch, Affiliation of the Innsbruck Medical University, Carinagasse 47, 6800 Feldkirch, Austria
Department of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstr. 8‑10, 91054 Erlangen, Germany
2
Nowadays, the majority of patients receive left ITA grafts to the left anterior descending (LAD) coronary artery and SV grafts or other conduits to the remaining vessels. Although the ITA has patency rates of 90–95% 10–15 years after CABG, SV gra
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