Document Detail


Pharmacological relaxation of the saphenous vein during harvesting for coronary artery bypass grafting.
MedLine Citation:
PMID:  8494433     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Spasm of the saphenous vein frequently occurs during harvesting from the leg and high-pressure distension is required to restore an adequate diameter for grafting. Forceful distention has been shown to damage the intima and media and may predispose to subsequent occlusion of the vein graft. Various pharmacologic vasodilators are capable of relaxing veins; in this study, we carried out a systematic investigation to determine the appropriate agents and concentrations for use during vein graft operations. In organ baths, human saphenous vein segments were contracted with potassium or a thromboxane mimetic, and vasodilator agents were then applied. Glyceryl trinitrate, 7.2 micrograms/mL, or papaverine hydrochloride, 11.9 micrograms/mL, caused 80% to 100% relaxation of contraction induced by potassium or thromboxane. Verapamil, 15.5 micrograms/mL, relaxed the potassium contraction by 100% and the thromboxane contraction by 75%. Comparison of the time course of action showed that glyceryl trinitrate had a rapid onset and a short duration of maximal action, whereas verapamil (like papaverine) had delayed onset and a long duration. A mixture of glyceryl trinitrate and verapamil combined rapid onset with long duration of action. We now use a mixture of glyceryl trinitrate and verapamil (pH 7.4) topically and intraluminally during harvesting of the saphenous vein to provide a relaxed conduit for coronary artery bypass grafting.
Authors:
G W He; F L Rosenfeldt; J A Angus
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  55     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1993 May 
Date Detail:
Created Date:  1993-06-17     Completed Date:  1993-06-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1210-7     Citation Subset:  AIM; IM    
Affiliation:
Baker Medical Research Institute, Melbourne, Australia.
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Bypass* / methods
Diltiazem / administration & dosage,  pharmacology
Dose-Response Relationship, Drug
Female
Humans
Male
Middle Aged
Nitroglycerin / administration & dosage,  pharmacology
Papaverine / administration & dosage,  pharmacology
Phenylephrine / administration & dosage,  pharmacology
Potassium / administration & dosage,  pharmacology
Pressure
Prostaglandin Endoperoxides, Synthetic / administration & dosage,  pharmacology
Saphenous Vein / drug effects*,  pathology,  physiopathology,  transplantation*
Stress, Mechanical
Time Factors
Vasoconstrictor Agents / administration & dosage,  pharmacology
Vasodilator Agents / administration & dosage,  pharmacology*
Verapamil / administration & dosage,  pharmacology
Chemical
Reg. No./Substance:
0/Prostaglandin Endoperoxides, Synthetic; 0/Vasoconstrictor Agents; 0/Vasodilator Agents; 42399-41-7/Diltiazem; 52-53-9/Verapamil; 55-63-0/Nitroglycerin; 58-74-2/Papaverine; 59-42-7/Phenylephrine; 7440-09-7/Potassium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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