Journals / Haydarpaşa Numune Medical Journal / 2020 / Cilt: 60 - Sayı: 1

Comparison of Iloprost and Papaverine in Topical Vasodilation of Internal Mammary Artery in Coronary Artery Bypass Grafting: A Prospective Randomized Trial

Pages
76–84
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

There was no significant difference between the two groups in terms of postoperative mortality and complications.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Introduction: Internal mammary artery (IMA) graft is a commonly used coronary artery bypass conduit due to its high longterm patency rates.
📊
Key Findings & Data:Methods: Between May-August 2009, 40 consecutive patients who underwent coronary artery bypass grafting using IMA graft were included in this prospective study.
💡
Conclusion & Impact:There was no significant difference between the two groups in terms of postoperative mortality and complications.
🔬Design:Research Article
📍Scope:2009 Verileri
⚙️Variables:Domain Parameters

Özet

Introduction: Internal mammary artery (IMA) graft is a commonly used coronary artery bypass conduit due to its high longterm patency rates. IMA may have a perioperative arterial spasm problem. Papaverine, an opium alkaloid, is commonly used in vasospasm, especially for IMA. Iloprost, a synthetic prostacyclin analogue, could be an alternative to papaverine. In this study, we compared the effects of topical iloprost and papaverine concerning the prevention of IMA vasospasm. Methods: Between May-August 2009, 40 consecutive patients who underwent coronary artery bypass grafting using IMA graft were included in this prospective study. Patients were divided into two groups to be treated with topical vasodilators as iloprost and papaverine groups. The free blood flow of IMA was measured before and after the topical vasodilators were applied. These results were evaluated together with concurrently measured mean arterial pressures. Histopathologic examination was performed with the distal part of IMA and scored according to the desquamation rate. Results: Preoperative and haemodynamic parameters between the two groups were similar. With both vasodilator agents, the amount of IMA blood flow was increased in a similar ratio as well. Analysis of this increase was assessed by dividing the blood flow by the mean arterial blood pressure value. Iloprost group had similar vasodilation response when compared with the response of the papaverine group. There was more desquamation in the papaverine group at a significant level. There was no significant difference between the two groups in terms of postoperative mortality and complications.

🔖

Cite This Article

YALVAÇ, E. Ş. D., BALKANAY, O. O., GÖKSEDEL, D., AKİ, S. H., ÖMEROĞLU, S. N., İPEK, G. (2020). Comparison of Iloprost and Papaverine in Topical Vasodilation of Internal Mammary Artery in Coronary Artery Bypass Grafting: A Prospective Randomized Trial. Haydarpaşa Numune Medical Journal, Cilt: 60 - Sayı: 1, 76–84. https://ajindex.com/articles/160883

📄 Full Text PDF Viewer

↗New Tab

References (13)

  1. Fiore AC, Naunheim KS, Dean P, Kaiser GC, Pennington G, Willman VL, et al. Results of internal thoracic artery grafting over 15 years: single versus double grafts. Ann Thorac Surg 1990;49:202–9
  2. Sarabu MR, McClung JA, Fass A, Reed GE. Early postoperative spasm in left internal mammary artery bypass grafts. Ann Thorac Surg 1987;44:199–200
  3. Dregelid E, Heldal K, Andersen KS, Stangeland L, Svendsen E. Dilation of the internal mammary artery by external papaverine application to the pedicle--an improved method. Eur J Cardiothorac Surg 1993;7:158–62
  4. Sasson L, Cohen AJ, Hauptman E, Schachner A. Effect of topical vasodilators on internal mammary arteries. Ann Thorac Surg 1995;59:494–6
  5. Salmenperä M, Levy JH. The in vitro effects of phosphodiesterase inhibitors on the human internal mammary artery. Anesth Analg 1996;82:954–7
  6. Cooper GJ, Wilkinson GA, Angelini GD. Overcoming perioperative spasm of the internal mammary artery: which is the best vasodilator? J Thorac Cardiovasc Surg 1992;104:465–8
  7. Johns RA, Peach MJ, Flanagan T, Kron IL. Probing of the canine mammary artery damages endothelium and impairs vasodilation resulting from prostacyclin and endothelium-derived relaxing factor. J Thorac Cardiovasc Surg 1989;97:252–8. 8. van Son JA, Tavilla G, Noyez L. Detrimental sequelae on the wall of the internal mammary artery caused by hydrostatic dilation with diluted papaverine solution. J Thorac Cardiovasc Surg 1992;104:972–6
  8. He GW. Arterial grafts for coronary artery bypass grafting: biological characteristics, functional classification, and clinical choice. Ann Thorac Surg 1999;67:277–84
  9. Rosenfeldt FL, He GW, Buxton BF, Angus JA. Pharmacology of coronary artery bypass grafts. Ann Thorac Surg 1999;67:878– 88
  10. Fuster V. Alexander R, O'Rourke RA, Roberts R, editors. Hurst the heart. 10th ed. McGraw-Hill; 2001. p. 1109–26
  11. Moncada S, Gryglewski R, Bunting S, Vane JR. An enzyme isolated from arteries transforms prostaglandin endoperoxides to an unstable substance that inhibits platelet aggregation. Nature 1976;263:663–5
  12. Kadowitz PJ, Chapnick BM, Feigen LP, Hyman AL, Nelson PK, Spannhake EW. Pulmonary and systemic vasodilator effects of the newly discovered prostaglandin, PGI2. J Appl Physiol Respir Environ Exerc Physiol 1978;45:408–13
  13. Mulvin D, Jones K, Howard R, Grosso M, Repine J, Johnston M. The effect of prostacyclin as a constituent of a preservation solution in protecting lungs from ischemic injury because of its va