Endothoracic papaverine application for internal thoracic artery harvest.
This study compared the effects of different methods of papaverine application on free blood flow and harvesting time of the internal thoracic artery for coronary bypass grafting. Patients were randomly divided into 3 groups of 25 each: group 1 had papaverine injected into the endothoracic tissue around the internal thoracic artery before dissection, group 2 had papaverine injected into the periarterial tissues of the internal thoracic artery pedicle, and group 3 had intraluminal papaverine applied retrogradely into the internal thoracic artery. Mean blood flow was 56.3 +/- 21.3, 21.1 +/- 13.2, and 20.9 +/- 9.1 mL x min(-1) in groups 1, 2, and 3, respectively, immediately after harvesting. Flow in group 1 was significantly better than that in groups 2 and 3. Immediately before anastomosis, mean flow was 89.8 +/- 19.1, 97.6 +/- 35.4, and 95.9 +/- 19.9 mL x min(-1) in groups 1, 2, and 3, respectively, with no significant difference among groups. Internal thoracic artery harvesting times were shorter in group 1 than in groups 2 and 3. Administering papaverine into the endothoracic fascia of the internal thoracic artery bed prior to dissection is a reliable method that facilitates rapid harvesting of the graft without causing trauma and consequent spasm.
Bahcivan
Muzaffer
M
Department of Cardiovascular Surgery, Faculty of Medicine, Ondokuz Mayis University, 55139 Kurupelit, Samsun, Turkey. mbahcivan@omu.edu.tr
Kolbakir
Fersat
F
Karamustafa
Hakan
H
Keceligil
H Tahsin
HT
D000368:Aged; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D004333:Drug Administration Routes; D005260:Female; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000187:drug effects* / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010208:Papaverine / Q000008:administration & dosage*; D012039:Regional Blood Flow / Q000187:drug effects; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014654:Vascular Patency / Q000187:drug effects; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D010208:Papaverine