High-flow gas insufflation to facilitate MIDCABG: effects on coronary endothelium William R Burfeind, MD, Francis G Duhaylongsod, MD, Brian H Annex, MD,

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High-flow gas insufflation to facilitate MIDCABG: effects on coronary endothelium William R Burfeind, MD, Francis G Duhaylongsod, MD, Brian H Annex, MD, David Samuelson, BA The Annals of Thoracic Surgery Volume 66, Issue 4, Pages 1246-1249 (October 1998) DOI: 10.1016/S0003-4975(98)00597-9

Fig 1 Surgical preparation. The stabilizing foot-plate was used to facilitate coronary artery dissection. The Annals of Thoracic Surgery 1998 66, 1246-1249DOI: (10.1016/S0003-4975(98)00597-9)

Fig 2 Photomicrograph, immunohistochemically stained with a mouse anti-human tie-2 monoclonal antibody, depicts the appearance of an unexposed control segment of left anterior descending coronary artery. All three layers of vessel wall are visible. Note the dark staining of the endothelium. (×13.2 before 35% reduction.) The Annals of Thoracic Surgery 1998 66, 1246-1249DOI: (10.1016/S0003-4975(98)00597-9)

Fig 3 (A) Photomicrograph, immunohistochemically stained with a mouse anti-human tie-2 monoclonal antibody, depicts the appearance of a segment of left anterior descending coronary artery that underwent arteriotomy and was exposed to high-flow gas insufflation at 15 L/min for 20 minutes. (B) Higher power magnification of box marked in A. This demonstrates the near-complete loss of endothelium after gas insufflation. The arrow in A points to an adventitial blood vessel endothelium that is staining red, providing an internal control. (C) Elastin stain of previous section demonstrating an intact internal elastic lamina. (A, ×25; B, ×66; C, ×66; all before 31% reduction.) The Annals of Thoracic Surgery 1998 66, 1246-1249DOI: (10.1016/S0003-4975(98)00597-9)

Fig 4 Photomicrograph, immunohistochemically stained with a mouse anti-human tie-2 monoclonal antibody, depicts the appearance of a segment of left anterior descending coronary artery that underwent an arteriotomy and was exposed to room air for 20 minutes. (×33 before 46% reduction.) The Annals of Thoracic Surgery 1998 66, 1246-1249DOI: (10.1016/S0003-4975(98)00597-9)