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

Abstract

Background: Numbers of intercellular and vascular cell adhesion molecules (ICAM and VCAM) and major ligands on endothelial cells for adherence of activated polymor-phonuclear 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, respec-tively) (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.