Long-term outcomes of venous graft preservation in a rat autologous transplant model

Abstract

Abstract Venous grafts remain the most used conduits in coronary artery bypass grafting (CABG) but are highly susceptible to early failure due to ischemia–reperfusion injury, intimal hyperplasia, and accelerated atherosclerosis. Specialized preservation solutions such as DuraGraft and TiProtec aim to protect endothelial integrity during intraoperative storage; however, their long-term effects on venous graft adaptation remain unclear. In this study, saline, DuraGraft, and TiProtec were compared in a rat model of arterialized autologous jugular vein interposition grafting. Male Wistar rats were assigned to one of the three storage solutions or a Sham group with immediate implantation. Jugular veins were harvested, preserved for 2 h, and implanted into the infrarenal abdominal aorta using end-to-end microsurgical anastomoses. After 16 weeks, all grafts remained patent and exhibited pronounced arterial remodeling, including dilation, wall thickening, intimal hyperplasia, and loss of endothelium-dependent relaxation, while endothelium-independent relaxation was preserved. Although TiProtec-treated grafts showed slightly enhanced relaxation compared with saline-treated grafts, no preservation solution demonstrated a significant functional or structural advantage at 16 weeks. These findings suggest that long-term arterial loading is the dominant determinant of venous graft remodeling.