| Effect of systemic vasodilators on internal mammary artery flow. Implications for postoperative treatment after myocardial revascularization. | |
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MedLine Citation:
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PMID: 8028383 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Postoperative spasm of the internal mammary artery graft can cause morbidity and mortality after myocardial revascularization. To our knowledge, the ability of systemic vasodilators to overcome internal mammary artery spasm has not been studied clinically. In 50 patients in whom the left internal mammary artery was used for myocardial revascularization, we have investigated the effect of five agents on internal mammary artery free flow: normal saline, dobutamine, glyceryl trinitrate, sodium nitroprusside, and enoximone, a phosphodiesterase III inhibitor. After the internal mammary artery was harvested, free flow was measured under controlled hemodynamic conditions before any pharmacologic intervention (flow 1) and a mean of 18.5 +/- 3 (standard deviation) minutes after a systemic infusion of one of the five agents was begun (flow 2). The increase in free flow expressed as a percentage of initial flow was greater for enoximone (94% +/- 24%) than for normal saline (18% +/- 11%), dobutamine (40% +/- 27%), and glyceryl trinitrate (52% +/- 36%) (all three p < 0.01). The increase in flow for sodium nitroprusside (78% +/- 37%) was greater than for normal saline and dobutamine (both p < 0.05). We therefore recommend the systemic use of enoximone and sodium nitroprusside, in rank order, to prevent and treat postoperative spasm of the internal mammary artery. |
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Authors:
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M B Izzat; R R West; C Ragoonanan; G D Angelini |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 108 ISSN: 0022-5223 ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 1994 Jul |
Date Detail:
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Created Date: 1994-08-09 Completed Date: 1994-08-09 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 82-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiac Surgery, University of Bristol, United Kingdom. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Blood Flow Velocity
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drug effects Dobutamine / administration & dosage Enoximone / administration & dosage Female Humans Internal Mammary-Coronary Artery Anastomosis* Male Mammary Arteries / drug effects, physiology* Middle Aged Nitroglycerin / administration & dosage Nitroprusside / administration & dosage Postoperative Care* Postoperative Complications / drug therapy, prevention & control Spasm / drug therapy, etiology, prevention & control Vasoconstriction / drug effects Vasodilator Agents / administration & dosage* |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 15078-28-1/Nitroprusside; 34368-04-2/Dobutamine; 55-63-0/Nitroglycerin; 77671-31-9/Enoximone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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