A comparative study on in vitro and in vivo effects of topical vasodilators in human internal mammary, radial artery and great saphenous vein

Ding, Rongjing; Wei, Feng; Li, Hongwei; Wang, Lei; Li, Dalian; Cheng, Zhiguang; Guo, Jianzhong; Hu, Dayi

doi:10.1016/j.ejcts.2008.05.050

Cited by 28 publications

(14 citation statements)

References 15 publications

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“…The lower capacity of NO release contributes to the susceptibility of RA to atherosclerosis, and is therefore responsible for the inferior longterm graft patency. 19,20 Late graft degeneration is rare in ITA grafts, and becomes more evident with longer patient followup. 1 In our study, the RITA was preferentially used as an in situ graft in 82% of patients and was predominantly routed through the transverse sinus.…”

Section: Discussionmentioning

confidence: 99%

“…The occurrence of a perioperative myocardial infarction is likely to be attributed to the known susceptibility of RA to vasospasm. 19,20 The lower incidence of stroke almost certainly reflects less aortic manipulation when a second ITA graft is used. BITA patients received significantly fewer central aortic anastomoses (23% of BITA patients did not receive central aortic anastomoses at all), eliminating the need for partial aortic clamping and second exposure to an embolic event.…”

Section: Discussionmentioning

confidence: 99%

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Second Internal Thoracic Artery Versus Radial Artery in Coronary Artery Bypass Grafting

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Second Internal Thoracic Artery Versus Radial Artery in Coronary Artery Bypass Grafting

et al. 2011

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“…Nitric oxide release contributes to the reduced susceptibility of arterial grafts to atherosclerosis. 17,18 Our study was observational and retrospective. Thus, we cannot rule out additional effects of missing covariates.…”

Section: Discussionmentioning

confidence: 99%

Multiple Arterial Grafts Improve Late Survival of Patients Undergoing Coronary Artery Bypass Graft Surgery

et al. 2012

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Background— Use of the left internal mammary artery (LIMA) in multivessel coronary artery disease improves survival after coronary artery bypass graft surgery; however, the survival benefit of multiple arterial (MultArt) grafts is debated. Methods and Results— We reviewed 8622 Mayo Clinic patients who had isolated primary coronary artery bypass graft surgery for multivessel coronary artery disease from 1993 to 2009. Patients were stratified by number of arterial grafts into the LIMA plus saphenous veins (LIMA/SV) group (n=7435) or the MultArt group (n=1187). Propensity score analysis matched 1153 patients. Operative mortality was 0.8% (n=10) in the MultArt and 2.1% (n=154) in the LIMA/SV ( P =0.005) group, which was not statistically different ( P =0.996) in multivariate analysis or the propensity-matched analysis ( P =0.818). Late survival was greater for MultArt versus LIMA/SV (10- and 15-year survival rates were 84% and 71% versus 61% and 36%, respectively [ P <0.001], in unmatched groups and 83% and 70% versus 80% and 60%, respectively [ P =0.0025], in matched groups). MultArt subgroups with bilateral internal mammary artery/SV (n=589) and bilateral internal mammary artery only (n=271) had improved 15-year survival (86% and 76%; 82% and 75% at 10 and 15 years [ P <0.001]), and patients with bilateral internal mammary artery/radial artery (n=147) and LIMA/radial artery (n=169) had greater 10-year survival (84% and 78%; P <0.001) versus LIMA/SV. In multivariate analysis, MultArt grafts remained a strong independent predictor of survival (hazard ratio, 0.79; 95% confidence interval, 0.66–0.94; P =0.007). Conclusions— In patients undergoing isolated coronary artery bypass graft surgery with LIMA to left anterior descending artery, arterial grafting of the non–left anterior descending vessels conferred a survival advantage at 15 years compared with SV grafting. It is still unproven whether these results apply to higher-risk subgroups of patients.

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“…Nitroglycerin has been reported to be effective in preventing spasm of radial artery graft. 13 The increase in GFF is in the range of 24 to 32 mL/min, but an increase of more than 100% has not been reported. Calcium channel blockers are the most frequently used vasodilator for radial artery.…”

Section: Commentmentioning

confidence: 97%

Fasudil is an Effective Graft Vasodilator for Gastroepiploic Artery in Coronary Artery Bypass Grafting

Watanabe

Yamaguchi

Tomita

et al. 2015

Innovations�(Phila)

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Objective The gastroepiploic artery (GEA) has been used as an alternative arterial in situ graft for coronary artery bypass grafting (CABG). However, because of the large individual differences and the spastic nature of the GEA, caution has to be exercised during harvesting. We evaluated the usefulness of fasudil, a Rho kinase inhibitor, as a vasodilator for right GEA (RGEA) graft after harvesting, compared with the conventional agents papaverine and verapamil-nitroglycerin. Methods Between June 2009 and January 2013, 30 patients with ischemic heart disease who underwent isolated CABG using RGEA graft were randomly assigned to fasudil (n = 10), papaverine (n = 10), or verapamil-nitroglycerin (n = 10) group. Fasudil (2.67 mmol/L), papaverine (1.0 mmol/L) mixed with heparinized blood, or verapamil-nitroglycerin (30 μmol/L each) was injected intraluminally into the RGEA graft after harvesting. Right GEA graft free flow (GFF), hemodynamic changes, and histopathology of RGEA were evaluated. Results Intraluminal injection of fasudil increased GFF significantly (P < 0.001) and markedly from 41.5 ± 31.5 mL/min at baseline to 149.3 ± 46.7 mL/min after injection. Papaverine increased GFF (P < 0.001) from 40.0 ± 35.8 to 64.9 ± 33.7 mL/min, and verapamil-nitroglycerin also increased GFF (P < 0.001) from 38.8 ± 32.1 to 79.0 ± 35.2 mL/min. The GFF was significantly higher (P = 0.001) in the fasudil group than in the other two groups. Histopathologically, fasudil treatment markedly increased the diameter of RGEA graft, while maintaining integrity of the multiple elastic lamellae. Blood pressure did not change significantly after drug injection in all groups. Conclusions Fasudil is more potent than papaverine or verapamilnitroglycerin in increasing GFF of RGEA graft for CABG.

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A comparative study on in vitro and in vivo effects of topical vasodilators in human internal mammary, radial artery and great saphenous vein

Abstract: (1) Comparing with nicorandil, urapidil and diltiazem, nitroglycerin caused a significant relaxation in all three graft vessels tested. (2) Nitroglycerin, nicorandil and urapidil were more effective in preventing RA spasm than diltiazem.

Cited by 28 publications

References 15 publications

Second Internal Thoracic Artery Versus Radial Artery in Coronary Artery Bypass Grafting

Second Internal Thoracic Artery Versus Radial Artery in Coronary Artery Bypass Grafting

Multiple Arterial Grafts Improve Late Survival of Patients Undergoing Coronary Artery Bypass Graft Surgery

Fasudil is an Effective Graft Vasodilator for Gastroepiploic Artery in Coronary Artery Bypass Grafting

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