Journal «Angiology and Vascular Surgery» • 

1997 • VOLUME 3 • №2

CONDUITS FOR MYOCARDIAL REVASCULARIZATION
(HISTOMORPHOLOGIC AND MORPHOMETRIC CORRELATIONS)

I.I. Berishvili, G.P. Vlasov, V.N. Ignatov, S.S. Dydykin, A.A. Kuryaev, Yu.N. Botnar
Department or Surgical Treatment of Concomitant Lesions of Coronary and Peripheral Arteries, A.N. Bakulev Scientific Center of Cardiovascular Surgery,
Russian Academy of Medical Sciences,
Moscow, Russia

The aim of the present work was to carry out histomorphologic and morphometric studies, to compare venous and most often used arterial conduits in order to identify the structural differences that determine one or another functional result ofmyocardial revascularisation. As a material for the studies we used 22 venous grafts from the saphenous veins taken on autopsy (4) or before coronary artery bypass grafting (18) and 56 arterial conduitsfrom the internal mammary artery (18), right gastroepiploic artery (14) and inferior epigastric artery (24) taken on autopsy. All the grafts were subjected to thorough histomorphologic and morphometric explorations. The internal, mammary artery has a denser internal elastic lamina. Its media contains a lot of elastic fibers with a scanty amount of smooth muscle cells. The gastroepiploic artery has a slightly fragmentary internal elastic lamina and its media is elastic fiber deficient. The internal epigastric artery has a scarce fenestration of the internal elastic lamina and its media is relatively poor in elastic fibers. In veins, the internal elastic lamina discontinues in many places. The media consists mainly of circulararranged bundles of smooth muscle cells. In a number of veins, the media shows the longitudinally arranged smooth muscle cell bundles. The venous wall is thicker than the arterial one and the venous media alone is thicker than the entire wall of arterial conduits. The ratio of the vessel thickness to its diameter was 0.41 in veins and 0.25 in arteries. Our findings indicate that the morphologic and morphometric characteristics of venous and arterial grafts have intrinsic dissimilarities. The presence of the compact internal elastic lamina, intact layer of smooth muscle cells and a relatively large quantity of elastic fibers allows for explaining advantages of arterial conduits over venous ones for myocardial revascularization.

P. 105

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