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Revista Colombiana de Cardiología
versão impressa ISSN 0120-5633
Resumo
LOPEZ-JARAMILLO, Patricio et al. Role of perivascular tissue in vascular tone regulation: repercussion in the use of aortocoronary bypass for myocardial revascularization. Rev. Col. Cardiol. [online]. 2007, vol.14, n.2, pp.100-107. ISSN 0120-5633.
Since more than thirty years, surgical insertion of autologous aortocoronary bypasses from saphenous vein and mammary artery constitute the election treatment for patients with severe coronary disease. The lifespan of these grafts has shown to be longer with arterial tissue even though its use is limited by its restricted availability. This is why the saphenous vein bypasses, although having a greater risk of presenting occlusion, are the most used in these procedures of myocardial reperfusion. The reasons by which the venous grafts are occluded after its insertion in the arterial site are still not clear; nevertheless, it has been proposed that it could be due to different factors such as: surgical mechanical trauma, increment of arterial pressure and diminished friction stress. In 1996 the «no-touch» preparation technique of venous grafts was described, in which the venous bypasses were implanted in the coronary site along with the surrounding perivascular tissue and demonstrated to improve the lifespan of this type of grafts. Recently it has been proposed that the perivascular fat tissue could play a role in the vascular tone regulation and it has been even described the existence of an adipose cell derived relaxing factor (ADRF), whose nature has not been completely cleared yet. The objective of this article is to review the different factors related to the aortocoronary grafts occlusion, the possible physiopathologic channels that form this phenomenon, the new surgical alternatives used for vein grafts preparation and the advances in the description of ADRF and its role in vascular tone regulation.
Palavras-chave : aortocoronary bypass; perivascular tissue; adipose cell derived relaxing factor.
