Intercellular and Vascular Cell Adhesion Molecule Levels in Endoscopic and Open Saphenous Vein Harvesting for Coronary Artery Bypass Surgery

(#2000-48999 ... June 8, 2000)

Sadir J Alrawi, MD, ¹ Mohammed Samee, MD, ¹ Ramanathan Raju, MD, ¹ Djamshid Shirazian, PhD² Anthony J. Acinapura, MD, ^1,3 Joseph N. Cunningham, MD^1,3

¹Department of Surgery
²Department of Immunology
³Division of Cardiothoracic Surgery
Maimonides & Lutheran Medical Center Research Institute, Brooklyn, New York

ABSTRACT

Background: Numbers of intercellular and vascular cell adhesion molecules (ICAM and VCAM) and major ligands on endothelial cells for adherence of activated polymorphnuclear leukocytes, macrophages, and lymphoid cells increase in many inflammatory disorders and after trauma to different tissues.

Methods: Samples of human saphenous veins were harvested from 90 randomly selected patients who underwent coronary artery bypass graft (CABG) surgery, utilizing two different techniques (open and endoscopic). Endothelial cells were collected from the vein samples and cultured for 72 hours. Pre- and postoperative sera, in addition to the supernatants from the cultures, were analyzed for ICAM-1 and VCAM-1 using enzyme-linked immunosorbent assay.

Results: Mean preoperative levels of ICAM-1 and VCAM-1 (0.95 ± 0.58 ng/mL and 1.81 ± 1.03 ng/mL, respectively) did not differ significantly from that of postoperative sera (0.98 ± 0.451 ng/mL and 1.74 ± 1.05 ng/mL, respectively) (p = 0.77 and p = 0.73, respectively). Mean ICAM-1 and VCAM-1 levels in endothelial cell culture supernatants did not differ significantly between the endoscopic (0.16 ± 0.05 ng/mL and 0.23 ± 0.10 ng/mL, respectively) and the open method (0.18 ± 0.08 ng/mL and 0.30 ± 0.27 ng/mL, respectively) (p = 0.19 and 0.13, respectively).

Conclusion: Our findings indicate that endoscopic and open saphenectomies are technically comparable in their effects on ICAM-1 and VCAM-1 synthesis during saphenous vein harvesting for CABG. We recommend the endoscopic method for its low morbidity and earlier hospital discharge.

AUTHOR/ARTICLE INFORMATION

Presented at the Third Annual Meeting of the International Society for Minimally Invasive Cardiac Surgery, Atlanta, Georgia, June 8-10, 2000

Presented at the annual meeting of the American College of Chest Physicians in Chicago, Illinois from October 31-November 4, 1999

Reprint requests to: Sadir J Alrawi, MD, FRCS, Department of Surgery, Surgical Research Office, Room 4423, Lutheran Medical Center, 150 55th Street, Brooklyn, NY 11220, Phone: (718) 630-7317, Fax: (718) 630-8216

Submitted on: This manuscript was peer reviewed and accepted for presentation at the Third Annual Meeting of the International Society for Minimally Invasive Cardiac Surgery, Atlanta, Georgia, June 8-10, 2000.

Acknowledgment: This project is supported by a grant from Maimonides Medical Center Research Foundation