BACKGROUND: Coronary artery bypass surgery provides excellent patency rates; however,
the early and/or late graft failure reduces the long-term benefit of myocardial revascularization.
We investigated the effectiveness of generally used saline, Custodiol solutions and
a new solution (TiProtec) at preserving endothelium after cold ischemia and warm reperfusion
injury. MATERIALS AND METHODS: Aortic transplantations were performed in Lewis rats.
Aortic arches were stored in saline, Custodiol, and TiProtec solutions for 2 h then
were transplanted into the abdominal aorta. Two, 24 hours and 1 week after transplantation,
the implanted grafts were harvested. Endothelium-dependent and -independent vasorelaxations
were investigated in organ bath. DNA strand breaks were assessed by terminal deoxynucleotidyl
transferase-mediated dUTP nick-end labeling-method, messenger RNA expressions by quantitative
real-time polymerase chain reaction, and the expression of CD-31 and alpha smooth
muscle actin by immunochemistry. RESULTS: Severely impaired endothelial function and
integrity of implanted aortic grafts were shown after 2 h in the saline, Custodiol
group (maximal vasorelaxation to acetylcholine: control: 91 +/- 2%, saline: 26 +/-
5%, Custodiol: 24 +/- 5%, CD-31-positive area control: 96 +/- 2%, saline: 35 +/- 13%
Custodiol: 54 +/- 5%, P < 0.05, respectively); however, a preserved endothelial function
was observed in the TiProtec group when compared with the saline and Custodiol group
(maximal vasorelaxation: 46 +/- 7%, CD-31-positive area: 54 +/- 10%, P < 0.05). After
1 wk, endothelial function was partially recovered in all groups; however, it was
significantly better in the TiProtec group (maximal vasorelaxation to acetylcholine:
saline: 42 +/- 3%, Custodiol: 48 +/- 3%, TiProtec: 56 +/- 3%, CD-31-positive area:
saline: 56 +/- 5%, Custodiol: 54 +/- 4%; TiProtec: 83 +/- 6%, P < 0.05, respectively).
In addition, messenger RNA levels of Bax, B-cell lymphoma-2, endothelial NOS, vascular
endothelial growth factor 2, and caspase-3 were significantly altered in both groups.
CONCLUSIONS: TiProtec appears to be superior for the preservation of endothelial-
and smooth muscle cells of bypass graft after cold storage and warm reperfusion in
our murine model.
