| Dilation of the internal mammary artery by external papaverine application to the pedicle--an improved method. | |
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MedLine Citation:
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PMID: 8096386 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Spasm of the internal mammary artery (IMA) during coronary bypass grafting may cause inadequate graft flow and makes accurate placement of sutures difficult. In addition, IMAs with poor intraoperative flow rates are more likely to occlude. In this study three methods for spasm prevention were compared in 51 patients undergoing coronary bypass surgery. In group 1, IMA pedicles were covered with a sponge soaked with papaverine solution (0.8 mg/ml of papaverine in 0.9% saline) and left intact distally, thus allowing continuous blood flow until used for bypass. In group 2, the IMAs were divided and clamped distally and the pedicle tucked into a papaverine-soaked sponge. In group 3, the IMAs were also divided distally, clamped, and placed under the upper sternum submerged in papaverine solution (0.8 mg/ml) inside a surgical glove. Free flow from the IMA was higher in group 3 than in groups 1 and 2 (60 ml/min vs. 44 and 30, respectively, P < 0.03). Morphometric measurements disclosed a larger luminal area and less folding of the internal elastic lamina in group 3 compared with groups 1 and 2 (0.73 mm2 vs 0.33 and 0.37, respectively, P < 0.03). Submersion in papaverine solution thus provides better procurement of IMA grafts than storage of the pedicle in a papaverine-soaked sponge. |
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Authors:
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E Dregelid; K Heldal; K S Andersen; L Stangeland; E Svendsen |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 7 ISSN: 1010-7940 ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 1993 |
Date Detail:
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Created Date: 1993-05-04 Completed Date: 1993-05-04 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: GERMANY |
Other Details:
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Languages: eng Pagination: 158-62; discussion 163 Citation Subset: IM |
Affiliation:
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Department of Heart Disease, Haukeland Hospital, Bergen, Norway. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Analysis of Variance Blood Flow Velocity / drug effects, physiology Coronary Artery Bypass / methods* Dilatation / methods Female Graft Occlusion, Vascular / prevention & control Humans Male Mammary Arteries / drug effects*, physiopathology, transplantation Middle Aged Muscle Contraction Myocardial Revascularization / methods* Papaverine / administration & dosage*, pharmacology Random Allocation Vascular Patency Vasodilator Agents / administration & dosage*, pharmacology |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 58-74-2/Papaverine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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