title: Nafamostat mesilate: can it be used as a conduit preserving agent in coronary artery bypass surgery?
abstract: BACKGROUND
  Graft vessel preservation solution in coronary artery bypass surgery is used to maintain the graft conduit in optimal condition during the perioperative period. Nafamostat mesilate (NM) has anticoagulation and anti-inflammatory properties. Therefore, we investigated NM as a conduit preservative agent and compared it to papaverine.
  
  
  METHODS
  Sprague-Dawley (SD) rat thoracic aortas were examined for their contraction-relaxation ability using phenylephrine (PE) and acetylcholine (ACh) following preincubation with papaverine and NM in standard classical organ baths. Human umbilical vein endothelial cells (HUVECs) were cultured to check for the endothelial cell viability. Histopathological examination and terminal deoxynucleotidyl transferase dUTP nick end labeling assay were performed on the thoracic aortas of SD rats.
  
  
  RESULTS
  The anti-contraction effects of papaverine were superior to those of NM at PE (p<0.05). The relaxation effect of NM on ACh-induced vasodilatation was not statistically different from that of papaverine. Viability assays using HUVECs showed endothelial cell survival rates of >90% in various concentrations of both NM and papaverine. A histopathological study showed a protective effect against necrosis and apoptosis (p<0.05) in the NM group.
  
  
  CONCLUSIONS
  NM exhibited good vascular relaxation and a reasonable anti-vasocontraction effect with a better cell protecting effect than papaverine; therefore, we concluded that NM is a good potential conduit preserving agent.
authors.affiliation: Department of Thoracic Surgery, Dongnam Institute of Radiological and Medical Science, Korea.
authors.forename: Yoo Sang
authors.initials: YS
authors.lastname: Yoon
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine, Korea.
authors.forename: Hyunkong
authors.initials: H
authors.lastname: Oh
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine, Korea.
authors.forename: Yonghwan
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine, Korea.
authors.forename: Seung Pyung
authors.initials: SP
authors.lastname: Lim
authors.affiliation: Department of Physiology, Chungnam National University School of Medicine. Korea.
authors.forename: Cuk-Seong
authors.initials: CS
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine, Korea.
authors.forename: Min-Woong
authors.initials: MW
authors.lastname: Kang
keywords: Anticoagulants; Coronary artery bypass conduits; Coronary artery bypass surgery