010 * ENDOSCOPIC VEIN HARVESTING IS ASSOCIATED WITH INCREASED ENDOTHELIAL MICROPARTICLE SECRETION: A RANDOMISED EX-VIVO ANALYSIS

Abstract

Abstract Objectives: Endoscopic vein harvesting (EVH) for coronary artery bypass graft surgery has been associated with both positive and negative clinical outcome in a range of studies. In the worst cases, relationships with increased occlusion, myocardial infarction and mortality have been described. EVH could induce endothelial damage leading to loss of graft function. In an attempt to assess endothelial integrity, this study was designed to compare endothelial injury using endothelial microparticle (EMP) secretion as a sensitive marker of dysfunction in vessels harvested using endoscopic versus standard techniques. Methods: A prospective randomised and technician-blinded study design was used to compare standard open technique (SOT, n = 10) vs EVH (n = 5). Once the vein had been harvested, 2°cm was cut after being filled with heparinised patient serum and clipped on either end. All the solution in the vein lumen was washed out using PBS and analysed using flow cytometry to quantify EMPs. Results: There were significantly more Annexin V + CD31 + EMPs in the EVH group compared to the SOT group (mean number of events = 4558.4 vs 86.5, P = 0.001), and also a significant increase in Annexin V + MPs in the EVH group (mean number of events = 4558.4 vs 1238.3, P = 0.027). Conclusion: In this ex-vivo study, EMP secretion was elevated in vessels harvested using endoscopic compared to standard open techniques, which is indicative of endothelial injury. This could contribute to the negative associations with EVH. Long-term clinical data is clearly warranted to translate these findings.