Verapamil and nitroglycerin improves the patency rate of radial artery grafts.
The best way to prevent spasm of the radial artery is still under investigation. We retrospectively compared the effectiveness of topical verapamil-nitroglycerin with papaverine in preventing graft spasm in 215 patients who underwent isolated conventional coronary artery bypass using a radial artery. Postoperative angiographic data were successfully collected in 116 patients. Perioperative radial artery graft spasm was observed in 2 patients in the papaverine group and 1 in the verapamil-nitroglycerin group; this difference was not considered significant. Complete or functional occlusion was detected by postoperative angiography in 13 grafts (10 in the papaverine group and 3 in the verapamil-nitroglycerin group). Multivariate regression analysis revealed that topical papaverine and grafting to the right coronary artery significantly increased the rate of occlusion of radial artery grafts. Although further studies are needed, our data support the view that topical verapamil-nitroglycerin reduces the incidence of radial artery graft occlusion.
Yoshizaki
Tomoya
T
Department of Cardiovascular Surgery, Yokohama City Minato Red Cross Hospital, 3-12-1 Shinyamashita, Naka-ku, Yokohama 231-8682, Japan. yoshizaki.tsrg@yokohama.jrc.or.jp
Tabuchi
Noriyuki
N
Toyama
Masaaki
M
D000287:Administration, Topical; D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004338:Drug Combinations; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage*; D010208:Papaverine / Q000008:administration & dosage*; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology / Q000637:transplantation; D011859:Radiography; D012189:Retrospective Studies; D013035:Spasm / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency / Q000187:drug effects*; D014665:Vasodilator Agents / Q000008:administration & dosage*; D014700:Verapamil / Q000008:administration & dosage*
D004338:Drug Combinations; D014665:Vasodilator Agents; D014700:Verapamil; D010208:Papaverine; D005996:Nitroglycerin