In Vitro Comparative Analysis of Arterial and Venous Grafts After Storage in Different Preservation Solutions During Coronary Bypass Surgery

All articles of this category (opens in new window) Background: CABG outcomes depend on graft patency, which is influenced by endothelial integrity during intraoperative storage. Arterial conduits (internal mammary artery, IMA; radial artery, RA) usually outperform venous grafts (saphenous vein, SV). We compared immediate graft function and histomorphology after short-term storage in contemporary solutions. Methods: Surplus segments from 127 elective CABG patients were stored for 2 hours at room temperature in 0.9% saline, TiProtec, or DuraGraft. Two-millimeter rings underwent myography (KCl screen; α1-mediated contraction to phenylephrine; endothelium-dependent relaxation to acetylcholine; endothelium-independent relaxation to sodium nitroprusside). Histology (H&E, Elastica van Gieson) measured intimal thickness and intima–media ratio (IMR); intimal hyperplasia (IH) was classified as none/eccentric/concentric. Associations with age, BMI, diabetes, hyperlipidemia, and hypertension were explored. Results: Across conduits, TiProtec/DuraGraft preserved vasomotor function better than saline, with the clearest, consistent benefits in arterial grafts (IMA/RA) for both ACh- and SNP-mediated relaxation. Phenylephrine responses differed only modestly. In SV, solution effects were small and variable, with occasional paradoxical responses. Histology showed preexisting structural change common in SV and universal in RA, whereas IMA often exhibited no IH. IH type differed by conduit ( p < 0.001): RA predominantly concentric, IMA predominantly eccentric, SV mixed but mainly concentric. Intimal thickness was lowest in IMA (IMA < SV < RA). RA had the highest IMR; IMA and SV were similar. Patient factors showed no significant associations of IMR with age, BMI, diabetes, hyperlipidemia, or hypertension. Conclusion: Short-term storage in optimized solutions better preserves immediate vasomotor function than saline, especially in arterial grafts. Conduit-specific remodeling suggests preexisting structure—particularly in SV—may limit functional rescue. These findings support standardizing arterial graft storage in evidence-based solutions and underscore the importance of venous graft quality assessment; prospective correlation with early graft quality and patency is warranted. Publication History Article published online: 17 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany