Vasorelaxant effects of the potassium channel opener SR 47063 on the isolated human saphenous vein and rat aorta

The vasorelaxant effects of SR 47063 (4-(2-cyanimino-1,2-dihydropyrid-1-yl)-2,2-dimethyl-6-nitrochromene), a new K+-channel opener structurally related to levcromakalim, were examined in isolated human saphenous vein (HSV) and rat aorta (RA). HSV or RA rings were precontracted with either KCl or noradrenaline and cumulative relaxant concentration-response curves were obtained for SR 47063 (0.1 nM to 1 µM) in the presence or absence of 3 µM glibenclamide. SR 47063 potently relaxed HSV and RA precontracted with 20 mM (but not 60 mM) KCl or 10 µM noradrenaline in a concentration-dependent manner, showing slightly greater activity in the aorta. The potency of the effect of SR 47063 on HSV and RA was 12- and 58-fold greater, respectively, than that reported for the structurally related K+-channel opener levcromakalim. The vasorelaxant action of SR 47063 in both blood vessels was strongly inhibited by 3 µM glibenclamide, consistent with a mechanism of action involving ATP-dependent K+-channels.

Experimental myocardial hypertrophy induced by a minimally invasive ascending aorta coarctation

Ascending aorta coarctation was produced by a minimally invasive technique in rabbits. Animal mortality was 5%. Morphometric and hemodynamic parameters were evaluated. A parabiotically isolated heart model was used to assess the hemodynamic parameters. Left ventricular weight/body weight ratio and muscle area showed clear evidence of hypertrophy when compared to control. The hemodynamic changes in the isolated heart model suggested decreased diastolic and systolic function in the coarcted group. The present model produced hypertrophy with low mortality rates as a result of its less invasive nature.

Calcium antagonism and the vasorelaxation of the rat aorta induced by rotundifolone

The vasorelaxing activity of rotundifolone (ROT), a major constituent (63.5%) of the essential oil of Mentha x villosa, was tested in male Wistar rats (300-350 g). In isolated rat aortic rings, increasing ROT concentrations (0.3, 1, 10, 100, 300, and 500 µg/ml) inhibited the contractile effects of 1 µM phenylephrine and of 80 or 30 mM KCl (IC50 values, reported as means ± SEM = 184 ± 6, 185 ± 3 and 188 ± 19 µg/ml, N = 6, respectively). In aortic rings pre-contracted with 1 µM phenylephrine, the smooth muscle-relaxant activity of ROT was inhibited by removal of the vascular endothelium (IC50 value = 235 ± 7 µg/ml, N = 6). Furthermore, ROT inhibited (pD2 = 6.04, N = 6) the CaCl2-induced contraction in depolarizing medium in a concentration-dependent manner. In Ca2+-free solution, ROT inhibited 1 µM phenylephrine-induced contraction in a concentration-dependent manner and did not modify the phasic contractile response evoked by caffeine (20 mM). In conclusion, in the present study we have shown that ROT produces an endothelium-independent vasorelaxing effect in the rat aorta. The results further indicated that in the rat aorta ROT is able to induce vasorelaxation, at least in part, by inhibiting both: a) voltage-dependent Ca² channels, and b) intracellular Ca2+ release selectively due to inositol 1,4,5-triphosphate activation. Additional studies are required to elucidate the mechanisms underlying ROT-induced relaxation.

Functional expression of kinin B1 and B2 receptors in mouse abdominal aorta

Previous studies have shown that the vascular reactivity of the mouse aorta differs substantially from that of the rat aorta in response to several agonists such as angiotensin II, endothelin-1 and isoproterenol. However, no information is available about the agonists bradykinin (BK) and DesArg9BK (DBK). Our aim was to determine the potential expression of kinin B1 and B2 receptors in the abdominal mouse aorta isolated from C57BL/6 mice. Contraction and relaxation responses to BK and DBK were investigated using isometric recordings. The kinins were unable to induce relaxation but concentration-contraction response curves were obtained by applying increasing concentrations of the agonists BK and DBK. These effects were blocked by the antagonists Icatibant and R-715, respectively. The potency (pD2) calculated from the curves was 7.0 ± 0.1 for BK and 7.3 ± 0.2 for DBK. The efficacy was 51 ± 2% for BK and 30 ± 1% for DBK when compared to 1 µM norepinephrine. The concentration-dependent responses of BK and DBK were markedly inhibited by the arachidonic acid inhibitor indomethacin (1 µM), suggesting a mediation by the cyclooxygenase pathway. These contractile responses were not potentiated in the presence of the NOS inhibitor L-NAME (1 mM) or endothelium-denuded aorta, indicating that the NO pathway is not involved. We conclude that the mouse aorta constitutively contains B1 and B2 subtypes of kinin receptors and that stimulation with BK and DBK induces contractile effect mediated by endothelium-independent vasoconstrictor prostanoids.

Lipolysis of emulsion models of triglyceride-rich lipoproteins is altered in male patients with abdominal aorta aneurysm

Disorders of the lipid metabolism may play a role in the genesis of abdominal aorta aneurysm. The present study examined the intravascular catabolism of chylomicrons, the lipoproteins that carry the dietary lipids absorbed by the intestine in the circulation in patients with abdominal aorta aneurysm. Thirteen male patients (72 ± 5 years) with abdominal aorta aneurysm with normal plasma lipid profile and 13 healthy male control subjects (73 ± 5 years) participated in the study. The method of chylomicron-like emulsions was used to evaluate this metabolism. The emulsion labeled with 14C-cholesteryl oleate and ³H-triolein was injected intravenously in both groups. Blood samples were taken at regular intervals over 60 min to determine the decay curves. The fractional clearance rate (FCR) of the radioactive labels was calculated by compartmental analysis. The FCR of the emulsion with ³H-triolein was smaller in the aortic aneurysm patients than in controls (0.025 ± 0.017 vs 0.039 ± 0.019 min-1; P < 0.05), but the FCR of14C-cholesteryl oleate of both groups did not differ. In conclusion, as indicated by the triglyceride FCR, chylomicron lipolysis is diminished in male patients with aortic aneurysm, whereas the remnant removal which is traced by the cholesteryl oleate FCR is not altered. The results suggest that defects in the chylomicron metabolism may represent a risk factor for development of abdominal aortic aneurysm.

The methyl ester of rosuvastatin elicited an endothelium-independent and 3-hydroxy-3-methylglutaryl coenzyme A reductase-independent relaxant effect in rat aorta

The relaxant effect of the methyl ester of rosuvastatin was evaluated on aortic rings from male Wistar rats (250-300 g, 6 rats for each experimental group) with and without endothelium precontracted with 1.0 µM phenylephrine. The methyl ester presented a slightly greater potency than rosuvastatin in relaxing aortic rings, with log IC50 values of -6.88 and -6.07 M, respectively. Unlike rosuvastatin, the effect of its methyl ester was endothelium-independent. Pretreatment with 10 µM indomethacin did not inhibit, and pretreatment with 1 mM mevalonate only modestly inhibited the relaxant effect of the methyl ester. Nω-nitro-L-arginine methyl ester (L-NAME, 10 µM), the selective nitric oxide-2 (NO-2) inhibitor 1400 W (10 µM), tetraethylammonium (TEA, 10 mM), and cycloheximide (10 µM) partially inhibited the relaxant effect of the methyl ester on endothelium-denuded aortic rings. However, the combination of TEA plus either L-NAME or cycloheximide completely inhibited the relaxant effect. Inducible NO synthase (NOS-2) was only present in endothelium-denuded aortic rings, as demonstrated by immunoblot with methyl ester-treated rings. In conclusion, whereas rosuvastatin was associated with a relaxant effect dependent on endothelium and hydroxymethylglutaryl coenzyme A reductase in rat aorta, the methyl ester of rosuvastatin exhibited an endothelium-independent and only slightly hydroxymethylglutaryl coenzyme A reductase-dependent relaxant effect. Both NO produced by NOS-2 and K+ channels are involved in the relaxant effect of the methyl ester of rosuvastatin.

Cirugía Abierta Versus Cirugía Endovascular en el Tratamiento de la Patología de la Aorta Torácica Descendente

El reparo endovascular de la aorta torácica (REVAT), se ha incrementado en el mundo en los últimos años con relación al abierto. Los resultados de la intervención son controversiales. La información en Colombia es insuficiente. Objetivo: Comparar los resultados clínicos del REVAT frente al reparo abierto en la Fundación Cardio Infantil (Bogotá, Col) entre 2002 y 2011. Metodología: Análisis retrospectivo de la cohorte de pacientes sometidos a reparo abierto (Grupo 1) en comparación de REVAT (grupo 2). En cada uno de los grupos se evaluó el tiempo quirúrgico, tasa de morbilidad (infección, hemo-rragia, isquemia medular, evento cerebrovascular [ECV] y falla renal postoperatoria), mortalidad, reintervención y estancia hospitalaria. Para las comparaciones se realizó un análisis univariado considerando un valor p<0.05 estadísticamente significativo. Resultados: Fueron incluidos 57 pacientes en el análisis (26% reparo abierto; 74% REVAT). Se reintervinieron 2 pacientes por endofugas tipo 1 en el Grupo 2 y un caso por sangrado en el Grupo 1. La mortalidad operatoria fue (Grupo1: 20%; Grupo 2: 2.3%). El tiempo quirúrgico fue de 398 ± 180 min Grupo 1 versus 85.5 ± 35 min en el Grupo 2 (p:0.0001) y el tiempo de estancia hospitalaria promedio fue de 9.8 días:Grupo 1 y 5,3 días Grupo 2 [p:0.01]). El tiempo promedio de seguimiento fue 4,8± 3,1 años. Conclusiones: El REVAT parece ofrecer menor morbilidad, mortalidad, tiempo quirúrgico y estancia hospitalaria respecto al reparo abierto, aunque las pobla-ciones de pacientes incluidos no fueron estrictamente comparables. Se requieren nuevos análisis en un diseño prospectivo, idealmente aleatorizado para documentar los beneficios a largo plazo de este tipo de reparo.

Avaliação da resposta clínica, inflamatória e infecciosa de crianças submetidas à cirurgia de coarctação da aorta com ou sem uso de precondicionamento isquêmico por pinçamento da aorta torácica descendente

Introdução: O precondicionamento isquêmico é o mais poderoso método experimental de proteção celular e pode ser aplicado em cirurgias que ocasionem isquemia tecidual como na correção de coarctação da aorta. Objetivo: Avaliar os resultados clínicos, inflamatórios e infecciosos de crianças submetidas à cirurgia de coarctação da aorta com ou sem uso de precondicionamento isquêmico por pinçamento da aorta torácica. Como desfechos primários foram avaliados os Eventos Adversos Principais (EAP) e o óbito em até 30 dias. Método: Foram analisados retrospectivamente os dados clínicos de 104 pacientes submetidos consecutivamente a cirurgia de coarctação da aorta entre dezembro de 2007 e dezembro de 2012 no Instituto Nacional de Cardiologia, Centro Pediátrico da Lagoa e Hospital Prontobaby na cidade do Rio de Janeiro. Foram constituídos dois grupos, G PRE: 27 pacientes submetidos ao precondicionamento e G CONT: 77 pacientes de controle Resultados: Houve predomínio do sexo masculino, 62,5%, a média de peso foi de 4,04±3,07 kg e 11,53% tinham peso < 2,5kg. A média de idade foi de 3,82±2, com mediana de 1,04 meses. A cirurgia foi realizada em caráter de emergência em 81,48% no G PRE (p<0,001) e o Basic e o Comprehensive Aristotle Score foram maiores no G CONT (p<0,001). A bandagem da artéria pulmonar foi realizada em 37,9% do G PRE contra 9,09% do G CONT e 81,48% do G PRE tiveram anastomose estendida no arco aórtico (p<0,001). As complicações aconteceram em 66,23% no G CONT e em 22,22% no G PRE (p<0,001). Os tempos de entubação traqueal, internação no CTI e internação hospitalar do G CONT foram 3 vezes (p=0,281), 2,44 vezes (p=0,175) e 1,7 vezes (p=0,196) maior que do G PRE. Os EAP aconteceram somente no G CONT (p>0,05), sendo mais comuns os abdominais (8,65%). Ocorreram três óbitos cirúrgicos (2,88%) todos no Grupo CONT (3,90%) (p=0,401). Nove pacientes (8,65%) tiveram óbito na internação da cirurgia, um do G PRE (3,70%) e oito do G CONT (10,39%) (p=0,265). As curvas livres de desfecho em 30 dias (100%) e 60 meses (74,07%) foram favoráveis para o Grupo PRE (p=0,007 e p=0,017). A análise multivariada de COX demonstrou que as variáveis: cateterismo venoso prévio, interrupção de arco aórtico, ventrículo único, hipertensão arterial pulmonar e a dupla via de saída de VD estão associados ao aumento de risco para desfecho nos pacientes do G PRE (p<0,05). Conclusão: Os pacientes do G PRE apresentaram maior complexidade e risco operatório e menores índices de complicação. Os desfechos foram mais comuns no G CONT mesmo sem diferença estatística. A evolução livre de desfecho com 30 dias e até 60 meses foi favorável para o G PRE. A análise multivariada revelou grupo de variáveis em que o pré- condicionamento é desfavorável para aparecimento de desfecho em 30 dias

Effects of isoproterenol treatment for 7 days on inflammatory mediators in the rat aorta

The aim of the present study was to evaluate the effect of overstimulation of beta-adrenoceptors on vascular inflammatory mediators. Wistar rats were treated with the beta-adrenoceptor agonist isoproterenol (0.3 mg(.)kg(-1.)day(-1) sc) or vehicle (control) for 7 days. At the end of treatment, the right carotid artery was catheterized for arterial and left ventricular (LV) hemodynamic evaluation. Isoproterenol treatment increased LV weight but did not change hemodynamic parameters. Aortic mRNA and protein expression were quantified by real-time RT-PCR and Western blot analysis, respectively. Isoproterenol enhanced aortic mRNA and protein expression of IL-1 beta (124% and 125%) and IL-6 (231% and 40%) compared with controls but did not change TNF-alpha expression. The nuclear-to-cytoplasmatic protein expression ration of the NF-beta B p65 subunit was increased by isoproterenol treatment (51%); in addition, it reduced the cytoplasmatic expression of I kappa B-alpha (52%) in aortas. An electrophoretic mobility shift assay was performed using the aorta, and increased NF-kappa B DNA binding (31%) was observed in isoproterenol-treated rats compared with controls (P < 0.05). Isoproterenol treatment increased phenylephrine-induced contraction in aortic rigs (P < 0.05), which was significantly reduced by superoxide dismutase (150 U/ml) and sodium salicylate (5 mM). Cotreatment with thalidomide (150 mg(.)kg(-1.)day(-1) for 7 days) also reduced hyperreactivity to phenylephrine induced by isoproterenol. In conclusion, overstimulation of beta-adrenoceptors increased proinflammatory cytokines and upregulated NF-kappa B in the rat aorta. Moreover, local oxidative stress and the proinflammatory state seem to play key roles in the altered vascular reactivity of the rat aorta induced by chronic beta-adrenergic stimulation.

Increased Activation of Stromal Interaction Molecule-1/Orai-1 in Aorta From Hypertensive Rats A Novel Insight Into Vascular Dysfunction

Disturbances in the regulation of cytosolic calcium (Ca(2+)) concentration play a key role in the vascular dysfunction associated with arterial hypertension. Stromal interaction molecules (STIMs) and Orai proteins represent a novel mechanism to control store-operated Ca(2+) entry. Although STIMs act as Ca(2+) sensors for the intracellular Ca(2+) stores, Orai is the putative pore-forming component of Ca(2+) release-activated Ca(2+) channels at the plasma membrane. We hypothesized that augmented activation of Ca(2+) release-activated Ca(2+)/Orai-1, through enhanced activity of STIM-1, plays a role in increased basal tonus and vascular reactivity in hypertensive animals. Endothelium-denuded aortic rings from Wistar-Kyoto and stroke-prone spontaneously hypertensive rats were used to evaluate contractions because of Ca(2+) influx. Depletion of intracellular Ca(2+) stores, which induces Ca(2+) release-activated Ca(2+) activation, was performed by placing arteries in Ca(2+) free-EGTA buffer. The addition of the Ca(2+) regular buffer produced greater contractions in aortas from stroke-prone spontaneously hypertensive rats versus Wistar-Kyoto rats. Thapsigargin (10 mu mol/L), an inhibitor of the sarcoplasmic reticulum Ca(2+) ATPase, further increased these contractions, especially in stroke-prone spontaneously hypertensive rat aorta. Addition of the Ca(2+) release-activated Ca(2+) channel inhibitors 2-aminoethoxydiphenyl borate (100 mu mol/L) or gadolinium (100 mu mol/L), as well as neutralizing antibodies to STIM-1 or Orai-1, abolished thapsigargin-increased contraction and the differences in spontaneous tone between the groups. Expression of Orai-1 and STIM-1 proteins was increased in aorta from stroke-prone spontaneously hypertensive rats when compared with Wistar-Kyoto rats. These results support the hypothesis that both Orai-1 and STIM-1 contribute to abnormal vascular function in hypertension. Augmented activation of STIM-1/Orai-1 may represent the mechanism that leads to impaired control of intracellular Ca(2+) levels in hypertension. (Hypertension. 2009; 53[part 2]: 409-416.)

Fenofibrate and Pioglitazone Do Not Ameliorate the Altered Vascular Reactivity in Aorta of Isoproterenol-treated Rats

Chronic stimulation of beta-adrenoceptors with isoproterenol induces alteration of vascular reactivity and increases local proinflammatory cytokines. We investigated whether fenofibrate and pioglitazone, PPAR-alpha and -gamma agonists, respectively, improve the changes in vascular reactivity induced by isoproterenol. Wistar rats received isoproterenol (0.3 mg.kg(-1).day(-1), SC) or vehicle (CT) plus fenofibrate (alpha, 100 mg.kg(-1).day(-1), PO), pioglitazone (gamma, 2.5 mg.kg(-1).day(-1), PO), or water for 7 days. In aortas, isoproterenol treatment enhanced the maximal response (Rmax) to phenylephrine (10(-10) to 10(-4) M) compared to CT as previously demonstrated. The effects of endothelium removal (E-) or L-NAME incubation (100 mu M) on the phenylephrine response were smaller in isoproterenol-treated animals compared to CT while superoxide dismutase (SOD, 150 U/mL) significantly reduced the Rmax to phenylephrine to CT levels. Neither fenofibrate nor pioglitazone changed the effects induced by isoproterenol in aorta. E-, L-NAME, or SOD effects were similar between CT alpha and CT. However, pioglitazone per se increased Rmax to phenylephrine (CT: 59 +/- 4 versus CT gamma: 72 +/- 5 % of contraction to KCl). E- or L-NAME effects were reduced in CT gamma compared to CT, and SOD normalized the altered reactivity to phenylephrine in the CT gamma group. In conclusion, neither fenofibrate nor pioglitazone ameliorates the altered vascular reactivity present in aorta from isoproterenol-treated rats. Moreover, pioglitazone per se induced endothelial dysfunction and increased phenylephrine-induced contraction in aorta.

Att leva med diagnosen Abdominellt Aorta Aneurysm : -en litteraturstudie om upplevelser kring sjukdom och omvårdnad ur ett patientperspektiv

Bakgrund: Över 150 000 människor i Sverige behandlas årligen för hjärt- och kärlsjukdom. En vanlig form är ateroskleros, åderförkalkning. Av alla de som idag avlider på grund av annan orsak än naturligt åldrande, gör de flesta det av komplikationer till aterosklerossjukdom. En av dessa komplikationer är aortaanerysm, mera känt som ”pulsåderbråck”. Det vanligast förekommande är abdominellt aortaanerysm, bukaortaaneurysm. Syfte: Syftet med denna studie var att belysa livssituationer, livskvalitet och omvårdnadsbehov hos patienter med diagnosen AAA samt att visa på omvårdnadsåtgärder som främjar hälsa hos patienter med denna diagnos. Metod: En litteraturgranskning gjordes i databaserna PubMed, Chinal och Psychinfo samt Högskolan Dalarnas sökmotor Elin. Artiklarna valdes ut efter relevans till syftet. Dess kvalitet värderades med hjälp av granskningsmallar. Fyra kvalitativa och 16 kvantitativa ansatser ingick i studien. Resultat: Det framkom att HRQoL hos patienter som fick diagnosen AAA försämrades signifikant perioperativt. Oro och rädsla samt känslor av overklighet, nära döden upplevelser och existentiella frågor var vanligt perioperativt. Ingen påvisbar skillnad före och efter screening i HRQoL eller upplevd hälsa iakttogs. Mer information kring exempelvis sexualitet perioperativt kunde lindra oro och rädsla. Diskussion: Omvårdnaden är otillräcklig vid diagnostillfället samt postoperativt. Screening har positiv inverkan på patienternas generella hälsa. Konklusion: Studien visade på ökat behov av omvårdnad i samband med att diagnosen ställts samt efter utskrivning postoperativt.

Análise morfométrica da parede arterial após o implante de stent em aorta abdominal de suínos : estudo comparativo entre stents metálicos não recobertos e recobertos com politetrafluoroetileno

O espessamento intimal e a reestenose que ocorrem após os procedimentos de angioplastia transluminal percutânea e/ou o implante de stents representam uma causa freqüente de falência destes procedimentos. O principal achado patológico responsável pela reestenose parece ser a hiperplasia intimal, já que o dispositivo intravascular é resistente ao remodelamento arterial geométrico. O propósito deste estudo é avaliar, através da morfometria digital, o espessamento intimal presente nas regiões da parede arterial imediatamente proximal e distal ao implante de um stent metálico em configuração em “Z “ não recoberto ou recoberto com PTFE. Vinte e cinco suínos de raça mista, com seis a dez semanas de idade, pesando em média 20 kg foram divididos em três grupos. No grupo I, cinco animais foram submetidos à exposição cirúrgica retroperitoneal da aorta abdominal, aortotomia e manipulação com uma bainha introdutora de 12 F. O grupo II incluiu dez animais que foram submetidos ao implante de um stent metálico auto-expansível não recoberto. No grupo III, incluindo também dez animais, foram implantados stents recobertos com PTFE. Após quatro semanas, todos os animais foram sacrificados e o segmento aorto-ilíaco foi removido. Quatro animais foram excluídos do estudo por trombose da aorta (um animal do grupo II e três animais do grupo III). Para a análise morfométrica foram utilizados os testes não paramétricos de Wilcoxon e de Kruskal-Wallis, para as comparações, respectivamente, no mesmo grupo e entre os grupos. Foi adotado o nível de significância de 5% ( p< 0,05). Quando os espécimes da parede arterial, imediatamente proximal e distal aos stents foram comparados, nenhuma diferença estatisticamente significativa foi encontrada entre as áreas luminal, intimal, média ou índice intimal em cada grupo. Na comparação entre os grupos, as áreas intimal, média e o índice intimal não demonstraram variação estatisticamente significativa. Foram identificadas diferenças entre os grupos quanto às áreas luminais proximais (p = 0,036) e distais (p=0,044). Pelo teste de comparações múltiplas para Kruskal-Wallis (Teste de Dunn) identificou-se diferença significativa entre os grupos I e II. Entretanto, quando estas variáveis foram controladas pelo fator peso (relação área luminal/peso) a diferença não foi mais observada. Concluímos que, após quatro semanas, stents recobertos com PTFE induzem um espessamento intimal justa-stent similar ao observado com stents não recobertos ou com a simples manipulação arterial com uma bainha introdutora. Neste modelo experimental suíno, de curto seguimento, o revestimento com PTFE não foi responsável por adicional espessamento intimal.

Healing process in anastomosis of homologous venous grafts preserved in glutaraldehyde implanted aorta of rabbits

Aim. Autologous vein (AV) is sometimes not suitable or present for a vascular restoration. Homologous vein preserved in glutaraldehyde may be an alternative to AV, but little is yet known about this graft and its healing process after implantation in arteries. The purpose of this study was to compare the initial healing process of glutaraldehyde-tanned homologous venous grafts (group 1) with fresh autologous venous grafts (group 2), at 4 or 15 days.Methods. Forty Norfolk rabbits were allocated in 2 groups of 20 animals each. The grafts was interposed in the infra-renal aorta of the rabbit. Anastomotic tensile strength (TS), hydroxyproline (HP) determination, and histology (HA) were performed.Results. TS increased in both groups, from the 4th to 15th day, (p < 0.01) in both proximal (G1: from 364.5 &PLUSMN; 98.3 g to 491.8 &PLUSMN; 107.3 g; G2: from 366.26 &PLUSMN; 85.15 g to 518.46 &PLUSMN; 82.79 g) and distal anastomosis (GI: from 363.53 &PLUSMN; 96.26 g to 507.32 &PLUSMN; 91.01 g; G2: from 352.30 &PLUSMN; 102.41 g to 528.67 &PLUSMN; 48.58 g), with no difference between the groups. HP did not change (p > 0.10) in this same period and was similar in both groups, in the proximal (GI: from 677.99 +/- 153.98 mug/100 mg to 914.92 +/- 459.83 mug/100 mg; G2: from 668.65 +/- 170.28 mug/100 mg to 669.46 +/- 319.80 mug/100 mg) as well as in the distal anastomosis (G1:from 740.07 +/- 213.53 mug/100 mg to 923.52 +/- 270.57 mug/100 mg; G2: from 737.66 +/- 266.76 mug/100 mg to 707.68 +/- 171.25 mug/100 mg). Initial inflammatory and reparative features of the anastomosis were similar in both groups.Conclusion. We can conclude that the healing process of the glutaraldehyde-tanned homologous vein graft was similar to that of the fresh autologous venous graft.

Cirurgia aórtica totalmente laparoscópica para tratamento de isquemia crítica de membros: relato do primeiro caso no Brasil

A cirurgia videolaparoscópica (CVL) vem evoluindo como alternativa cirúrgica menos invasiva para o tratamento da doença aterosclerótica oclusiva aortoilíaca. O objetivo deste relato de caso foi demonstrar os resultados da primeira cirurgia aórtica totalmente laparoscópica relatada no Brasil para o tratamento da doença oclusiva aortoilíaca em paciente com isquemia crítica. Os tempos cirúrgicos totais de dissecção e exposição da aorta antes do clampeamento, exposição retroperitoneal da aorta, clampeamento total e da anastomose proximal com técnica totalmente laparoscópica foram de 220 minutos, 15 e 27 minutos, 42 minutos, 110 minutos e 78 minutos, respectivamente. A técnica videolaparoscópica é mais uma ferramenta minimamente invasiva, viável, segura e eficaz para o tratamento da doença oclusiva aortoilíaca extensa. Ela, que nada mais é do que a cirurgia convencional realizada sob visão laparoscópica, tem bons resultados a longo prazo, que se associam à elegância técnica.