Intraoperative Vein Graft Preservation: What Is the Solution?

Saphenous vein graft (SVG) disease and subsequent vein graft failure remain a major problem after coronary artery bypass graft operations. In an effort to mitigate loss of endothelial viability, the vein is stored, intraoperatively, in a preservation solution. However, human SVG samples demonstrate endothelial denudation and dysfunction after such storage, the severity of which varies, depending on the medium. The paucity of clinical data evaluating preservation solutions is illustrated by the absence of optimal procedural protocol. This review evaluates the potential efficacy of different storage solutions in preserving vein grafts, in relation to a mechanistic understanding of SVG pathophysiology. (C) 2016 by The Society of Thoracic Surgeons