Domingos Sávio de Souza - Academia.edu (original) (raw)

Uploads

Papers by Domingos Sávio de Souza

Research paper thumbnail of O futuro da veia safena como conduto na cirurgia de revascularização miocárdica

Revista Brasileira De Cirurgia Cardiovascular, 2008

Research paper thumbnail of Retaining perivascular tissue of human saphenous vein grafts protects against surgical and distension-induced damage and preserves endothelial nitric oxide synthase and nitric oxide synthase activity

Journal of Thoracic and Cardiovascular Surgery, 2009

Objective: Conventional harvesting of saphenous vein used for coronary artery bypass surgery indu... more Objective: Conventional harvesting of saphenous vein used for coronary artery bypass surgery induces a vasospasm that is overcome by high-pressure distension. Saphenous vein harvested with its cushion of perivascular tissue by a ''no touch'' technique does not undergo vasospasm and distension is not required, leading to an improved graft patency. The aim of this study is to investigate the effect of surgical damage and high-pressure distension on endothelial integrity and endothelial nitric oxide synthase expression and activity in saphenous vein harvested with and without perivascular tissue.

Research paper thumbnail of Preparation of the saphenous vein for coronary artery bypass grafting: A new technique - "no touch" - that maintains the vein wall integral and provides high immediate patency Preparo da veia safena na cirurgia de revascularização miocárdica: uma nova técnica -"no touch"- que mantém a parede da v...

Preparation of the saphenous vein for coronary artery bypass grafting: A new technique -"no touch... more Preparation of the saphenous vein for coronary artery bypass grafting: A new technique -"no touch" -that maintains the vein wall integral and provides high immediate patency

Research paper thumbnail of Advantages of Harvesting the Saphenous Vein for Coronary Artery Bypass Surgery Using the “No-Touch” Technique

Surgery for direct myocardial revascularization was introduced at the end of the 1960s and has dr... more Surgery for direct myocardial revascularization was introduced at the end of the 1960s and has dramatically changed the management of patients with ischemic heart disease. In 1967 Favaloro successfully reconstructed the right coronary artery by interposing a segment of saphenous vein (SV) and, later, using the SV graft directly from the aorta to the coronary arteries, established the concept of SV grafting for coronary artery bypass surgery (CABG).1 Since then, the SV graft has been the most commonly used conduit.

Research paper thumbnail of Re: Perivascular tissue of internal thoracic artery releases potent nitric oxide and prostacyclin-independent anticontractile factor

European Journal of Cardio-thoracic Surgery, 2008

Research paper thumbnail of The no-touch technique of harvesting the saphenous vein for coronary artery bypass grafting surgery

Multimedia Manual of Cardiothoracic Surgery, 2009

A new 'no-touch' (NT) technique of saphenous vein (SV) preparation for coronary artery bypass gra... more A new 'no-touch' (NT) technique of saphenous vein (SV) preparation for coronary artery bypass grafting (CABG) surgery was developed where the vein is harvested with a pedicle of surrounding tissue, which protects the vein from spasm therefore obviating the need for distension. The adventitial layer and the structures contained within the cushion of surrounding tissue possess both mechanical and functional properties that protect the vein from spasm and ischemia. In addition, the surrounding tissue supports excessively long vein grafts and prevents kinking. A detailed description of the technique is presented and this is the first time we publish the technique as a videoclip.

Research paper thumbnail of Preparation of the saphenous vein for coronary artery bypass grafting: a new technique "no touch" that maintains the vein wall integral and provides high immediate patency

Revista Brasileira De Cirurgia Cardiovascular, 2003

BACKGROUND: The technique of harvesting the saphenous vein (SV) for coronary artery bypass grafti... more BACKGROUND: The technique of harvesting the saphenous vein (SV) for coronary artery bypass grafting (CABG) influences the fate of vein grafts. A new "no touch" (NT) technique of SV preparation was developed where the vein is harvested with a pedicle of surrounding tissue, which protects the vein from spasms therefore obviating the need for distension. METHOD: A prospective randomized study in 156 patients who underwent CABG was performed comparing three SV harvesting techniques. The techniques were conventional (c) (adventitial stripping of the vein, manual distention and storing in saline solution); Intermediate (I) (after adventitial stripping, the vein was left in situ, covered with a papaverine-soaked compress, and stored in heparinized blood); and "no touch" (SV dissected with its surrounding tissue was left in situ, covered with a saline-soaked compress and stored in heparinized blood). A morphological study of the endothelium was preformed using scanning electronic microscopy and an angiographic assessment of the vein graft patency was performed at 18 months mean follow-up time. Also an immunohistochemistry assessment was performed to identify the enzyme, nitric oxide synthase (NOS) in the vein wall. RESULTS: The preservation of the endothelial cell integrity was greater with the "no touch" technique than with the other procedures. At angiographic follow up, the patency for NT was 95.4%, 88.9% for grafts in group C and 86.2% for grafts in group I. The immunohistochemistry assessment revealed NOS in all three layers of the vein wall that was prepared by the "no touch" technique. However, a great reduction of this enzyme in veins treated by the conventional technique was observed. CONCLUSION: The endothelial integrity and NOS activity were better preserved when using the "no touch" technique for vein graft harvesting. The vasorelaxation and thrombo-resistant activities of nitric oxide (NO) may be responsible for the reduced of vasospasms and improved patency rate. Furthermore, the mechanical properties provided by the cushion of surrounding tissue in graft harvested by NT technique may contribute to the observed high patency rate.

Research paper thumbnail of O futuro da veia safena como conduto na cirurgia de revascularização miocárdica

Revista Brasileira De Cirurgia Cardiovascular, 2008

Research paper thumbnail of Retaining perivascular tissue of human saphenous vein grafts protects against surgical and distension-induced damage and preserves endothelial nitric oxide synthase and nitric oxide synthase activity

Journal of Thoracic and Cardiovascular Surgery, 2009

Objective: Conventional harvesting of saphenous vein used for coronary artery bypass surgery indu... more Objective: Conventional harvesting of saphenous vein used for coronary artery bypass surgery induces a vasospasm that is overcome by high-pressure distension. Saphenous vein harvested with its cushion of perivascular tissue by a ''no touch'' technique does not undergo vasospasm and distension is not required, leading to an improved graft patency. The aim of this study is to investigate the effect of surgical damage and high-pressure distension on endothelial integrity and endothelial nitric oxide synthase expression and activity in saphenous vein harvested with and without perivascular tissue.

Research paper thumbnail of Preparation of the saphenous vein for coronary artery bypass grafting: A new technique - "no touch" - that maintains the vein wall integral and provides high immediate patency Preparo da veia safena na cirurgia de revascularização miocárdica: uma nova técnica -"no touch"- que mantém a parede da v...

Preparation of the saphenous vein for coronary artery bypass grafting: A new technique -"no touch... more Preparation of the saphenous vein for coronary artery bypass grafting: A new technique -"no touch" -that maintains the vein wall integral and provides high immediate patency

Research paper thumbnail of Advantages of Harvesting the Saphenous Vein for Coronary Artery Bypass Surgery Using the “No-Touch” Technique

Surgery for direct myocardial revascularization was introduced at the end of the 1960s and has dr... more Surgery for direct myocardial revascularization was introduced at the end of the 1960s and has dramatically changed the management of patients with ischemic heart disease. In 1967 Favaloro successfully reconstructed the right coronary artery by interposing a segment of saphenous vein (SV) and, later, using the SV graft directly from the aorta to the coronary arteries, established the concept of SV grafting for coronary artery bypass surgery (CABG).1 Since then, the SV graft has been the most commonly used conduit.

Research paper thumbnail of Re: Perivascular tissue of internal thoracic artery releases potent nitric oxide and prostacyclin-independent anticontractile factor

European Journal of Cardio-thoracic Surgery, 2008

Research paper thumbnail of The no-touch technique of harvesting the saphenous vein for coronary artery bypass grafting surgery

Multimedia Manual of Cardiothoracic Surgery, 2009

A new 'no-touch' (NT) technique of saphenous vein (SV) preparation for coronary artery bypass gra... more A new 'no-touch' (NT) technique of saphenous vein (SV) preparation for coronary artery bypass grafting (CABG) surgery was developed where the vein is harvested with a pedicle of surrounding tissue, which protects the vein from spasm therefore obviating the need for distension. The adventitial layer and the structures contained within the cushion of surrounding tissue possess both mechanical and functional properties that protect the vein from spasm and ischemia. In addition, the surrounding tissue supports excessively long vein grafts and prevents kinking. A detailed description of the technique is presented and this is the first time we publish the technique as a videoclip.

Research paper thumbnail of Preparation of the saphenous vein for coronary artery bypass grafting: a new technique "no touch" that maintains the vein wall integral and provides high immediate patency

Revista Brasileira De Cirurgia Cardiovascular, 2003

BACKGROUND: The technique of harvesting the saphenous vein (SV) for coronary artery bypass grafti... more BACKGROUND: The technique of harvesting the saphenous vein (SV) for coronary artery bypass grafting (CABG) influences the fate of vein grafts. A new "no touch" (NT) technique of SV preparation was developed where the vein is harvested with a pedicle of surrounding tissue, which protects the vein from spasms therefore obviating the need for distension. METHOD: A prospective randomized study in 156 patients who underwent CABG was performed comparing three SV harvesting techniques. The techniques were conventional (c) (adventitial stripping of the vein, manual distention and storing in saline solution); Intermediate (I) (after adventitial stripping, the vein was left in situ, covered with a papaverine-soaked compress, and stored in heparinized blood); and "no touch" (SV dissected with its surrounding tissue was left in situ, covered with a saline-soaked compress and stored in heparinized blood). A morphological study of the endothelium was preformed using scanning electronic microscopy and an angiographic assessment of the vein graft patency was performed at 18 months mean follow-up time. Also an immunohistochemistry assessment was performed to identify the enzyme, nitric oxide synthase (NOS) in the vein wall. RESULTS: The preservation of the endothelial cell integrity was greater with the "no touch" technique than with the other procedures. At angiographic follow up, the patency for NT was 95.4%, 88.9% for grafts in group C and 86.2% for grafts in group I. The immunohistochemistry assessment revealed NOS in all three layers of the vein wall that was prepared by the "no touch" technique. However, a great reduction of this enzyme in veins treated by the conventional technique was observed. CONCLUSION: The endothelial integrity and NOS activity were better preserved when using the "no touch" technique for vein graft harvesting. The vasorelaxation and thrombo-resistant activities of nitric oxide (NO) may be responsible for the reduced of vasospasms and improved patency rate. Furthermore, the mechanical properties provided by the cushion of surrounding tissue in graft harvested by NT technique may contribute to the observed high patency rate.