HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Roberts, A. J. Articles by Alexander, J. A. Search for Related Content PubMed PubMed Citation Articles by Roberts, A. J. Articles by Alexander, J. A.

The Journal of Thoracic and Cardiovascular Surgery, Vol 88, 39-48, Copyright © 1984 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Biochemical and ultrastructural integrity of the saphenous vein conduit during coronary artery bypass grafting. Preliminary results of the effect of papaverine

AJ Roberts, DA Hay, JL Mehta, P Mehta, L Roy, RS Faro, DG Knauf and JA Alexander

Factors associated with early and late graft patency related to aorta- coronary artery bypass grafting with a reversed segment of saphenous vein are clinically important. The present investigation examines the biochemical and electron microscopic integrity of this venous conduit intraoperatively with regard to pharmacologic manipulation with papaverine. Portions of saphenous vein were analyzed in 22 patients undergoing coronary artery bypass operations. Levels of a stable derivative of prostacyclin, 6-keto-PGF1 alpha, were measured by radioimmunoassay. Scanning as well as transmission electron microscopy was also performed. In particular, the efficacy of local vein treatment with papaverine, a phosphodiesterase inhibitor, was evaluated. We found that levels of 6-keto-PGF1 alpha in venous effluent showed a biphasic response with initial elevation followed by a relative depression after papaverine exposure. There were no such changes observed in veins subjected to a balanced electrolyte solution (Plasma-Lyte). In addition, levels of the platelet-inhibitory substance 6-keto-PGF1 alpha in venous tissue were less in papaverine-treated veins than those found in veins treated only with the balanced electrolyte solution (Plasma- Lyte). Furthermore, evidence for ultrastructural damage was also somewhat greater in the papaverine-treated group. An alternative method of dilating the saphenous vein after harvesting, which involves the creation of the proximal aorta-coronary anastomosis first and gentle finger manipulation subsequently, appeared to minimize venous injury. Under present clinical conditions, it appears that some amount of injury is inevitable during harvesting and suturing of the human saphenous vein during coronary bypass grafting.

This article has been cited by other articles:

				A. Schlitt, D. Pruefer, U. Buerke, M. Russ, M. Dahm, H. Oelert, K. Werdan, and M. Buerke Neutrophil Adherence to Activated Saphenous Vein and Mammary Endothelium After Graft Preparation Ann. Thorac. Surg., April 1, 2006; 81(4): 1262 - 1268. [Abstract] [Full Text] [PDF]

				Z.-G. Liu, X.-C. Liu, A. P.C. Yim, and G.-W. He Direct measurement of nitric oxide release from saphenous vein: abolishment by surgical preparation Ann. Thorac. Surg., January 1, 2001; 71(1): 133 - 137. [Abstract] [Full Text] [PDF]

				F. L. Rosenfeldt, G.-W. He, B. F. Buxton, and J. A. Angus Pharmacology of coronary artery bypass grafts Ann. Thorac. Surg., March 1, 1999; 67(3): 878 - 888. [Abstract] [Full Text] [PDF]

				N. Roubos, F. L. Rosenfeldt, S. M. Richards, R. A.J. Conyers, and B. B. Davis Improved Preservation of Saphenous Vein Grafts by the Use of Glyceryl Trinitrate–Verapamil Solution During Harvesting Circulation, November 1, 1995; 92(9): 31 - 36. [Abstract] [Full Text]

				G.-W. He, B. F. Buxton, F. L. Rosenfeldt, J. A. Angus, and J. Tatoulis Pharmacologic dilatation of the internal mammary artery during coronary bypass grafting J. Thorac. Cardiovasc. Surg., June 1, 1994; 107(6): 1440 - 1444. [Abstract] [Full Text]

				A. M. Sanchez, T. A. Wooldridge, L. E. Boerboom, G. N. Olinger, G. H. Almassi, and N. J. Rusch Comparison of saphenous vein graft relaxation between Plasma-Lyte solution and normal saline solution J. Thorac. Cardiovasc. Surg., June 1, 1994; 107(6): 1445 - 1453. [Abstract] [Full Text]