Sequential multidetector computed tomography assessments after venous graft treatment solution in coronary artery bypass grafting

Commentary: How does the vein look? Intraoperative storage strategy and vein graft disease prevention

“…We congratulate Perrault and colleagues 3 for their elegant study in this issue of the Journal investigating the impact of intraoperative storage solution on VGD progression. The authors studied 125 individuals from 7 centers in 3 countries.…”

Preservation solutions to improve graft patency: The devil is in the detail

“…In a recent retrospective analysis, Haime et al showed that treatment of saphenous vein grafts with (the hospital compounded) GALA solution in patients undergoing isolated coronary artery bypass grafting was associated with a 45% lower occurrence of non-fatal MI, a 35% lower risk for revascularization and 19% lower major adverse cardiac events respectively starting at 1000 days post CABG [10]. Moreover, in a randomized multicenter clinical trial using a within-patient randomization design and sequential multidetector computed tomography angiography at 1, 3, and 12 months after CABG, Perrault et al and colleagues found favorable effects on wall thickness (as a surrogate of VGF/VGD) of DuraGraft treated SVGs at 12 months, particularly in the proximal segments [4]. The study also showed a good safety profile for DuraGraft with very low rates of graft occlusion and occurrence of MI, and no deaths [4].…”

“…Preservation solutions to improve graft patency: The devil is in the detail Etem Caliskan 1,2 , Catherine J. Pachuk 3 , Louis P. Perrault 4 and Maximilian Y. Emmert 1,2* We read with great interest the article by Fourquet and colleagues exploring whether autologous heparinized blood (AHB), heparinized saline (HS) and GALA (considered as their reference solution) have a protective effect on vein grafts interposed in the arterial position at 6 weeks post grafting in a syngeneic rat model [1].…”

“…First, we would like to point out that the solution used in the present study and referred to as GALA neither has the same composition as the GALA solution which was developed and used at the Veterans Affairs laboratories in Boston [2] nor is it comparable to the currently commercially available DuraGraft [3,4]. In fact, it is to be recognized that the solution used by Fourquet and colleagues has an 11.4 mM ascorbic acid concentration which is 23-fold higher than the 0.5 mM ascorbic acid concentration used in the GALA solution or DuraGraft.…”

“…In particular, this is also due to the fact, that their findings are highly contradictory to the preclinical and clinical data available for the hospital compounded GALA solution and the commercially available Dura-Graft (which was formulated based on the GALA solution) [2,4,9,10].…”