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Intraoperative administration of clevidipine to prevent vasospasm after radial and internal mammary artery grafts during coronary artery bypass grafting.
MedLine Citation:
PMID:  20634670     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
During coronary artery bypass graft surgery, various arterial and venous conduits have been used to carry blood flow from the aorta to the coronary vasculature. Arterial conduits provide certain advantages over the saphenous vein, including superior long-term patency, relative resistance to the development of atherosclerosis, and greater endothelium-dependent relaxation. However, the perioperative release of catecholamines and thromboxane A, mechanical manipulation, and underlying endothelial cell dysfunction may result in vasoconstriction or vasospasm of the arterial conduit and a compromise of myocardial perfusion. Given these issues, pharmacologic therapy is frequently initiated intraoperatively to prevent vasospasm. Clevidipine is a rapidly acting calcium channel antagonist. Like nicardipine, it is a member of the dihydropyridine subgroup. Its rapid metabolism by tissue and plasma esterases results in an effective half-life of 1 to 3 minutes. We report, for the first time, the perioperative use of clevidipine to prevent vasospasm after coronary artery bypass graft surgery with the use of internal mammary artery and bilateral radial artery conduits. Its potential application in this scenario and advantages when compared with other commonly used agents is discussed.
Authors:
Mitesh Patel; Thomas Meyer; Ajit Tharakan; Joseph D Tobias
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of therapeutics     Volume:  19     ISSN:  1536-3686     ISO Abbreviation:  Am J Ther     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9441347     Medline TA:  Am J Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e114-7     Citation Subset:  IM    
Affiliation:
Departments of 1Anesthesiology and 2Cardiothoracic Surgery, University of Missouri, Columbia, MO 3Departments of Anesthesiology and Pediatrics, Nationwide Children's Hospital and the Ohio State University, Columbus, OH.
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