Aim. The left internal thoracic artery (LITA) is the conduit of choice for grafting the left anterior descending artery. Vascular spasm is a well-recognized response to LITA harvest and many different vasodila- tors have been used to increase LITA flow or to prevent the spasm. Nevertheless, the best vasodilator agent is not known. Since 2001, we routinely use a combination of Glyceril-trinitrate and Verapamil (called GV-solution) either topically and intraluminally. The aim of this study is to evaluate if any difference exists between the use of GV-solution and Papaverine to prevent LITA spasm and increase LITA flow. Methods. One hundred consecutive patients undergoing CABG were randomized into 3 groups: group-GV (33 patients) treated with GV solution, group-P (33 patients) with Papaverine, group-C (34 patients) as control group with normal saline. In every patient pedi- cled LITA was harvested, then after complete dissection irrigated with solution and covered with a soaked sponge. LITA was distally transected 5 minutes after heparin infusion, before cardiopulmonary bypass LITA free flow was measured over a 15-seconds period and flow per minute was calculated; this was considered as the flow after vasodilator topical administration (T-flow). (Figure 1). After, the vasodilator was injected intraluminally by an olive-tipped needle and a second free flow per minute was collected, considered as flow after intraluminal infusion (I-flow). (Figure 2). 

Effects of papaverine and glyceril-trinitrate/verapamil solution on internal thoracic artery flow: a prospective randomized study / Brustia, M; Formica, F; Colagrande, L; Corti, F; Bosisio, E; Paolini, G.. - In: JOURNAL OF CARDIOVASCULAR SURGERY. - ISSN 0021-9509. - 46:Suppl 1, N 3(2005), pp. 25-25.

Effects of papaverine and glyceril-trinitrate/verapamil solution on internal thoracic artery flow: a prospective randomized study

Formica F;
2005

Abstract

Aim. The left internal thoracic artery (LITA) is the conduit of choice for grafting the left anterior descending artery. Vascular spasm is a well-recognized response to LITA harvest and many different vasodila- tors have been used to increase LITA flow or to prevent the spasm. Nevertheless, the best vasodilator agent is not known. Since 2001, we routinely use a combination of Glyceril-trinitrate and Verapamil (called GV-solution) either topically and intraluminally. The aim of this study is to evaluate if any difference exists between the use of GV-solution and Papaverine to prevent LITA spasm and increase LITA flow. Methods. One hundred consecutive patients undergoing CABG were randomized into 3 groups: group-GV (33 patients) treated with GV solution, group-P (33 patients) with Papaverine, group-C (34 patients) as control group with normal saline. In every patient pedi- cled LITA was harvested, then after complete dissection irrigated with solution and covered with a soaked sponge. LITA was distally transected 5 minutes after heparin infusion, before cardiopulmonary bypass LITA free flow was measured over a 15-seconds period and flow per minute was calculated; this was considered as the flow after vasodilator topical administration (T-flow). (Figure 1). After, the vasodilator was injected intraluminally by an olive-tipped needle and a second free flow per minute was collected, considered as flow after intraluminal infusion (I-flow). (Figure 2). 
Effects of papaverine and glyceril-trinitrate/verapamil solution on internal thoracic artery flow: a prospective randomized study / Brustia, M; Formica, F; Colagrande, L; Corti, F; Bosisio, E; Paolini, G.. - In: JOURNAL OF CARDIOVASCULAR SURGERY. - ISSN 0021-9509. - 46:Suppl 1, N 3(2005), pp. 25-25.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2875650
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