J.Jpn. Surg. Soc.. 96(7): 466-472, 1995

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Original article

EARLY CHANGES AT ANASTOMOTIC SITES OF SAPHENOUS VEIN GRAFTS AFTER CORONARY ARTERY BYPASS GRAFTING

Saphenous vein grafts are known to develop intimal fibrocellular proliferation, however, there is little information regarding early changes of intimal fibrocellular proliferation after coronary artery bypass grafting (CABG). This study is based on 6 distal anastomotic sites obtained at autopsy from 3 patients who died within 9 days after CABG. The anastomotic sites were sectioned serially and studied with conventional and immunocytochemical techniques. Endothelial cells at all anastomotic sites showed desquamations. In two cases at 2 and 3 days after CABG, the luminal surfaces of anastomotic sites were covered by fibrin-platelet thrombus with infiltration of T-lymphocytes and macrophages. At these sites, moreover, some spindle-shaped cells were also present. Immunocytochemically, these spindle-shaped cells, which were stained with vimentin but negative with both anti-actin markers HHF35 and CGA7, were considered to be de-differentiated smooth muscle cells. In the case at 9 days after CABG, cellular reactions were mainly composed of macrophages and de-differentiated smooth muscle cells. In conclusion, these observations in human saphenous vein grafts at an early stage suggest that 1) endothelial denudation leads to adhesion of fibrin-platelet thrombus and subsequent cellular responce, 2) T-lymphocytes and macrophages may play an important role in an early stage of intimal fibrocellular proliferation.

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