Comparing the Effects of Krebs Plus Verapamil Solution on Endothelial Function of Harvested Human Greater Saphenous Vein with Heparinized Blood, an Invitro Study.

INTRODUCTION: Integrity of the great saphenous vein (GSV) endothelium is the most important key element for long-term patency rate of grafts in coronary artery bypass graft (CABG). Storage solutions play an important role in maintaining viability of vein endothelium. Diminished nitric oxide (NO) because of endothelial dysfunction may facilitate vascular inflammation and formation of atherosclerotic plaque. AIM: So, we decided to find a reasonable alternative preservative solution instead of heparinized blood (HB) by measuring NO concentration with Griess assay. MATERIAL AND METHOD: SVG samples were obtained from 54 patients undergoing elective CABG. 3 mm rings were stored in solutions: heparinized blood (HB), Krebs (K), Krebs + Propranolol (K+P) 6.66 g/l, Krebs + Adrenaline (K+A) 200 µl/l, and Krebs + Verapamil (K+V) 200 µl/l for 30, 45, 60 and 90 min. Nitrite concentration was measured by Griess assay at 540 nm. H&E staining was performed for histologic test. Statistical analysis was performed using SPSS (V16). Results were expressed as (Means ± SE) followed by One-Way ANOVA for finding best preservative solution. Repeated measurement test was used to investigate best time. In all analysis, (P<0.05) was considered significant. RESULTS: Average concentration of NO in (K+V) compare with HB (1st control), K (2nd control), (K+A) and (K+P) showed higher rate in all times from 30 to 90 min (16.55±1.85:) and in (K+A, K+P) compare with (HB) and (K) there was no statistically significant difference in the same times. Comparing the average concentration of (NO) between (HB) and (K) showed no significant difference (K+V>HB=K=K+A=K+P). Also, our investigations showed that NO concentration in (K+V) has the highest rate in time 90 min (10.07±0.56, p=0.002):. More than 50 percent of endothelial cells stay normal in (K+V) compare with other solutions. CONCLUSION: It seems that (K+V) is the best solution for the maintenance of normal physiology of SVGs endothelial cells. The most appropriate SVGs endothelial function is within 90 minutes after harvesting.

Prevalence of acute blood transfusion reactions in Mazandaran Heart Center, Sari, Iran, 2010-2012.

INTRODUCTION: Although blood transfusion is life saving for patients, it is responsible for a series of complications and exposes the patients to a variety of risks. Therefore knowing different adverse effects of blood transfusion represents a great issue in managing recipient patients. AIM: The aim of the present work was to study the prevalence of blood transfusion complications among patients in the Mazandaran Heart Center, Sari, Iran, during a period of 2 years. MATERIAL AND METHODS: A retrospective review of all reported and evaluated acute transfusion reactions during a 2 years period in Mazandaran Heart Center was performed. Associated clinical signs and symptoms were evaluated. RESULTS: In 9193 transfused blood products, there was 34 (0.4%) acute transfusion reactions. The commonest were discomfort and restlessness (0.16%), dyspnea (0.16%), rigors (0.13%), fever (0.08%), chest pain (0.06%), rash or urticaria (0.04%), nausea and vomiting (0.03%), palpitation (0.03%), hypertension (0.03%) flashing (0.02%), hypotension (0.02%). CONCLUSION: Acute transfusion reaction is seen in %0.4 of transfused patients therefore, we recommend a well-structured program for monitoring adverse reactions associated with blood transfusion and blood product administration (Hemovigilance program).