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Open Access 01-12-2008 | Research article

Accelerated intimal hyperplasia in aortocoronary internal mammary vein grafts in minipigs

Authors: Aron Frederik Popov, Hilmar Dorge, Jose Hinz, Jan Dieter Schmitto, Tomislav Stojanovic, Ralf Seipelt, Vassilios Didilis, Friedrich Albert Schoendube

Published in: Journal of Cardiothoracic Surgery | Issue 1/2008

Abstract

Background

More than 50% of aortocoronary saphenous vein grafts are occluded 10 years after surgery. Intimal hyperplasia is the initial critical step in the progression toward occlusion. Internal mammary veins, which are physiologically prone to less hydrostatic pressure, may undergo an accelerated progression to intimal hyperplasia and thus be suitable for investigation of the mechanisms of aortocoronary vein graft disease.

Methods

Six minipigs underwent aortocoronary bypass grafting using standard cardiopulmonary bypass and cardioplegic arrest. Mammary vein were grafted in a reversed manner from ascending aorta to left anterior descending coronary artery (LAD). The proximal LAD was ligated, rendering the anterior left ventricle vein graft-dependent. Minipigs were killed after 4 weeks, and vein grafts were harvested. Histological and immunohistological investigation were performed with respect to morphometric analysis, endothelial damage/dysfunction (v-Willebrand-factor (vWF)), smooth muscle cells (α-smooth actin) and proliferation rate (proliferation marker Ki 67).

Results

Mean intimal area of vein grafts was increased compared to ungrafted mammary veins. Intimal hyperplasia in vein grafts was characterized by massive accumulation of smooth muscle cells with a high proliferation rate and endothelial perturbation. Significant (p = 0.001) intimal hyperplasia of the grafted mammary vein compared to the ungrafted mammary vein was found. These changes were absent in ungrafted mammary veins.

Conclusion

The present study demonstrates a pig model of aortocoronary vein graft intimal hyperplasia which is characterized by an accelerated progression within internal mammary veins. The model is suitable to investigate the pathophysiology of aortocoronary vein graft intimal hyperplasia as well as therapeutic approaches.

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Title: Accelerated intimal hyperplasia in aortocoronary internal mammary vein grafts in minipigs
Authors: Aron Frederik Popov
Hilmar Dorge
Jose Hinz
Jan Dieter Schmitto
Tomislav Stojanovic
Ralf Seipelt
Vassilios Didilis
Friedrich Albert Schoendube
Publication date: 01-12-2008
Publisher: BioMed Central
Published in: Journal of Cardiothoracic Surgery / Issue 1/2008
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/1749-8090-3-20

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Accelerated intimal hyperplasia in aortocoronary internal mammary vein grafts in minipigs

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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